British Journal of Ophthalmology最新文献

{"title":"Efficacy of spectacle lenses for myopia control: a meta-analysis of randomised controlled trials","authors":"Luca D’Andrea, Michele Rinaldi, Raffaele Piscopo, Fabiana Iorio, Simone La Padula, Sundas Maqsood, Mohamed Elalfy, Antonietta Melenzane, Filippo Confalonieri, Ozlem Ozkan, Canan Asli Utine, Ciro Costagliola","doi":"10.1136/bjo-2025-327629","DOIUrl":"https://doi.org/10.1136/bjo-2025-327629","url":null,"abstract":"Purpose To determine the effects of advanced spectacle lens technologies on changes in spherical equivalent of refraction (SER) and axial length (AL) elongation in slowing down the progression of myopia in children and adolescents, by synthesising data from randomised controlled trials (RCTs). Methods A systematic review and meta-analysis was conducted to identify all RCTs up to 27 February 2025 that compared intervention groups with myopia control lenses and control groups with standard single vision lenses (SVLs). Data from eligible studies were extracted into specially-designed data collection forms without changing the original values. Means and SD for continuous outcomes were determined and imported into RevMan. Results This meta-analysis included 23 RCTs with a total of 13.315 subjects. Compared with SVLs, myopia control lenses significantly reduced AL (−0.15 mm; 95% CI −0.20 to −0.09; p<0.00001) and SER progression (−0.31 D; 95% CI −0.42 to −0.20; p<0.00001). Highly Aspherical Lenslet lenses significantly reduced AL (−0.28 mm; 95% CI −0.37 to −0.19) and SER progression (−0.52 D; 95% CI −0.84 to −0.20). Defocus Incorporated Multiple Segments lenses also significantly reduced SER (−0.45 D; 95% CI −0.65 to −0.26), although only one eligible RCT reported AL data. Other lens types had modest or variable effects. Conclusions This meta-analysis provides an up-to-date and detailed comparative evaluation of spectacle lens designs for myopia control, based exclusively on RCTs. These findings support the use of specialty lenses as an effective, non-invasive strategy to reduce the risks associated with high-myopia and guide optimal lens selection in clinical practice. PROSPERO registration number CRD420251009898 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":"11 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003166","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":"Association of leucocyte telomere length with incident age-related macular degeneration: a prospective UK Biobank Study","authors":"Jun Yu, Yuzhou Zhang, Mary Ho, Ka Wai Kam, Alvin L Young, Chi Pui Pang, Clement C Tham, Jason C Yam, Li Jia Chen","doi":"10.1136/bjo-2025-327492","DOIUrl":"https://doi.org/10.1136/bjo-2025-327492","url":null,"abstract":"Purpose There have been conflicting findings on the role of leucocyte telomere length (LTL) in the risk of age-related macular degeneration (AMD). In this study, we evaluated the associations between LTL and the risk of incident AMD and explored whether age, sex and/or genetic predisposition to AMD can modify these associations. Methods We conducted a longitudinal cohort study involving 332 123 AMD-free participants with complete baseline covariates and LTL data from the UK Biobank. We employed multivariable Cox proportional hazards models to test the association between LTL and AMD incidence, estimating the HRs and 95% CIs. Genetic risk was assessed using polygenic risk score (PRS). Results During a median follow-up of 13.63 years, 6754 participants (2.03%) developed AMD. Shorter LTL was not associated with incident AMD risk (HR=1.042, 95% CI: 0.992 to 1.094; p=0.10) after adjusting for multiple confounders. Sex showed an interactive effect with LTL (p=0.01 for interaction) on incident AMD risk, while age and PRS did not modify these associations. We identified a significant association between shorter LTL and incident AMD risk in females (HR=1.093, 95% CI: 1.025 to 1.166; p=0.007), but not in males. Moreover, shorter LTL was associated with thinner photoreceptor segments only in females at both baseline and repeated assessments (β=−0.141 µm, 95% CI: −0.267 to −0.016; β=−0.345 µm, 95% CI: −0.649 to −0.041, p<0.05). Conclusions Shorter LTL increased the risk of incident AMD in females, suggesting LTL as a potential biomarker for AMD development with sex-specific function. Data are available in a public, open access repository. Data are available in a public, open access repository. This present study was conducted under application number 91320 of the UK Biobank resource. Data can be accessed through applications on UK Biobank website (<https://www.ukbiobank.ac.uk/>).","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"33 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995491","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":"Quantifying the correlation of ocular manifestations and macular pigment optical density in albinism: a prospective cross-sectional study.","authors":"Pınar Bingöl Kızıltunç,Huban Atilla","doi":"10.1136/bjo-2025-327286","DOIUrl":"https://doi.org/10.1136/bjo-2025-327286","url":null,"abstract":"AIMSTo demonstrate the presence of macular pigments in patients with albinism using colour perimetry and to evaluate the relationship between macular pigment optical density (MPOD) and ocular findings.METHODS50 patients were included. Best-corrected visual acuities (BCVAs) were measured at 2 meters (Early Treatment Diabetic Retinopathy Study charts) and recorded as logMAR. Iris transillumination defect was graded as 5 on a 5-point scale. The severity of foveal hypoplasia was graded as 4 on a 4-point scale using optical coherence tomography. After fixating on a light source 3 cm away for 10 seconds, the time taken to read three letters from the BCVA row was measured as photostress recovery time. MPOD and macular pigment mean defect were measured quantitatively using colour perimetry.RESULTSMedian BCVA was 0.8 logMAR. Median photostress recovery time was 8 seconds. MPOD measurements were acquired from all eyes except two eyes (4%). Median MPOD and macular pigment mean defect were 0.63 decibel (dB) and 4.34 dB, respectively. There was a statistically significant negative correlation between MPOD and BCVA-logMAR, and a positive correlation between macular pigment mean defect and BCVA-logMAR. No statistically significant correlation was found between grade of iris transillumination defect, photostress recovery time and grade of foveal hypoplasia.CONCLUSIONSPatients with albinism have macular pigments, and these can be determined by colour perimetry. Eyes with higher macular pigments tend to have better visual acuity. This finding suggests that supplementation with retinal carotenoids could be a promising therapeutic approach for albinism, as it may increase macular pigment density, leading to improved visual acuity.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960236","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":"Topical β-blockers for treatment of glaucoma and the risk of Parkinson's disease.","authors":"Amit Meshi,Nir Giladi,Alon Zahavi,Itay Elimelech Gabbay,Orly Gal-Or,Assaf Dotan,Sivan Gazit,Tal Patalon,Yuval Kozlov,Noa Geffen,Shiri Shulman","doi":"10.1136/bjo-2024-326689","DOIUrl":"https://doi.org/10.1136/bjo-2024-326689","url":null,"abstract":"BACKGROUND/AIMSReports have suggested that treatment with systemic β-adrenoceptor antagonists (β-blockers) may increase the risk of developing Parkinson's disease (PD). The objective of this study was to assess the association between the use of topical β-blockers and PD.METHODSA retrospective cohort study. All newly diagnosed glaucoma patients between 2000 and 2020 were recruited from the anonymised electronic medical records of a large healthcare provider. Patients were followed until December 2021 for the occurrence of PD. The patients were divided into two groups according to topical β-blocker use. Cox proportional-hazards models were used, and HRs with 95% CIs were calculated.RESULTSThe cohort included 13 381 glaucoma patients, of whom 10 075 used topical β-blockers (βB group) and 3306 did not (no-βB group). Demographic characteristics were similar between groups. Mean follow-up time and mean number of filled prescriptions for anti-glaucoma medication (total and annually) were significantly greater in the βB group (p<0.0001). During follow-up, 175 patients (1.31%) were diagnosed with PD, 145 in the βB group and 30 in the no-βB group. The HR for PD among topical β-blocker users compared with non-users was 1.16 (95% CI 0.78 to 1.72, p=0.47). Kaplan-Meier analysis showed no significant difference in PD-free survival between the groups (p=0.47).CONCLUSIONSTopical β-blocker use was not associated with an increased risk of PD. These findings suggest that topical β-blockers are a safe therapeutic option, even for patients at potential risk for PD.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"46 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960241","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-2025-328328","DOIUrl":"https://doi.org/10.1136/bjo-2025-328328","url":null,"abstract":"DeepSeek-R1 demonstrated an impressive 82% accuracy across 300 ophthalmology clinical cases, matching OpenAI o1’s diagnostic performance while reducing token costs approximately 15-fold. Its robust clinical reasoning but also high cost-effectiveness clearly underline its potential as an accessible AI tool. This study examined heterogeneity in Sjögren's syndrome, reporting that certain ocular metrics (grittiness, tear abnormalities) related to oral dryness while others (burning) related to extraocular pain. These observations suggest disparate mechanisms underlying presentations, perhaps related to nerve (dys)function. Cataract surgery is linked to a lower risk of dementia, especially Alzheimer’s disease, in patients with cataract. However, reported findings in this study indicate that the protective effect is diminished in those with common mental disorders. Low corneal hysteresis was associated with increased glaucoma incidence, with the …","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"12 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899091","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":"Reactivation of retinopathy of prematurity after anti-VEGF treatment: a review","authors":"Devesh Kumawat, Sindhuja Kandasamy, Parijat Chandra","doi":"10.1136/bjo-2025-327597","DOIUrl":"https://doi.org/10.1136/bjo-2025-327597","url":null,"abstract":"Anti-vascular endothelial growth factor (anti-VEGF) agents have demonstrated efficacy and short-term safety in the treatment of retinopathy of prematurity (ROP), establishing them as the preferred option for zone I and zone II posterior disease. Despite their advantages, the effects of anti-VEGF agents are relatively temporary. Consequently, ROP may reactivate or recur if retinal vascularisation has not sufficiently progressed and significant areas of avascular anterior retina remain while the anti-VEGF agents are cleared from the vitreous cavity. Extreme prematurity, early onset of ROP and severe disease at baseline (aggressive ROP or zone I disease) significantly increase this risk. Reactivated ROP presents differently from initial ROP presentation and may be subtle on clinical examination; however, it can often be detected earlier with fluorescein angiography. The interval and rates of reactivation vary depending on the type and dose of anti-VEGF agents, with occurrences sometimes delayed for years after an initial quiescent period. This necessitates close follow-up after anti-VEGF monotherapy until retinal vascularisation is complete or laser treatment is administered to the persistent peripheral avascular retina. On reactivation, the condition may be managed with repeat injections or laser treatment. Repeated anti-VEGF injections pose risks, including vascular arrest, persistent avascular retina, endophthalmitis and systemic toxicity. Late-detected reactivations or cases unresponsive to initial treatments may require vitrectomy. Generally, retreatment leads to disease regression with favourable structural outcomes. Currently, longer-acting drugs and prophylactic laser treatment of the avascular anterior retina are the only supported strategies for reducing reactivation.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"57 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144924034","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 manifestations and treatment outcomes in leukaemia: a comparative analysis of clinical spectrum, visual prognosis and predictors of disease remission across subtypes","authors":"Dhwanee Agarwal, Mudit Tyagi, Rajeev K R Pappuru, Vishal Raval","doi":"10.1136/bjo-2025-327835","DOIUrl":"https://doi.org/10.1136/bjo-2025-327835","url":null,"abstract":"Aim To conduct an analysis of ophthalmic manifestations in leukaemic patients and evaluate their impact on visual outcomes and disease remission. Methods This retrospective, comparative study included 244 patients (378 eyes) diagnosed with leukaemias between January 2016 and 2024. Data included demography, leukaemia type, ophthalmic manifestations, imaging modalities, treatment modalities (ocular and systemic), treatment outcomes (relapses or remission) and final visual acuity. Univariate and multivariate regression analyses were performed to identify correlations and predictive features associated with visual outcomes. Results The mean age of patients was 34.9±22.1 years (range, 1–88 years). Acute lymphocytic leukaemia was the most common subtype (58%), followed by chronic myeloid leukaemia (CML; 20%). Acute forms manifested earlier in life and were more aggressive. The presence of posterior segment manifestations (64%) was more than anterior segment manifestations (52%). Myeloid leukaemia types were more often associated with haemorrhagic manifestations, whereas lymphoid types were associated with non-haemorrhagic manifestations. Univariate regression analysis showed that the presence of epiretinal membrane (OR 0.110, 95% CI 0.012 to 0.951, p=0.04), submacular haemorrhage (OR 0.091, 95% CI 0.010 to 0.763, p=0.027) and type of leukaemia (acute myeloid leukaemia (AML) (OR 3.195, 95% CI 1.697 to 6.012, p<0.000) or CML (OR 6.39, 95% CI 3.130 to 13.041, p<0.000)) had significant association with poor visual outcome. Multivariate regression analysis revealed AML (OR 2.769, 95% CI 1.392 to 5.507, p=0.004) and CML (OR 7.313, 95% CI 3.326 to 16.074, p<0.000) as independent predictors of poor visual outcome. Conclusion Ophthalmic manifestations are major diagnostic and prognostic clues for leukaemias. Pattern recognition facilitates timely recognition, risk stratification, management and disease remission prediction. 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":"10 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915678","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":"Disease-specific and overall survival for patients with lacrimal gland adenoid cystic carcinoma in recent decades","authors":"Bita Esmaeli, Zhouxuan Li, Tracy J Lu, Hila Goldberg, Jing Ning, James Matthew Debnam, Steven Jay Frank, Renata Ferrarotto","doi":"10.1136/bjo-2025-327745","DOIUrl":"https://doi.org/10.1136/bjo-2025-327745","url":null,"abstract":"Purpose To evaluate the presenting symptoms, and the overall survival (OS) and disease-specific survival (DSS) in patients with lacrimal gland adenoid cystic carcinoma (LGACC). Methods This retrospective single-centre cohort study included all consecutive patients with LGACC treated by the primary author from November 1998 through August 2024. Demographic data, presenting symptoms, the histological subtype of LGACC, type of surgical treatment, adjuvant radiotherapy or chemotherapy, T category at presentation and survival data were reviewed. Correlations between histological subtypes, T-category, type of surgery (eye sparing vs orbital exenteration), and DSS and OS were analysed. Results 52 patients had a median age of 43.5 years (range: 9–71). Pain was the most common symptom but was only present in 17 patients (33%), 26 patients (50%) had orbital exenteration and 25 (48%) had eye-sparing surgery. Eye-sparing surgery was offered to selected patients only since 2007. Overall, 47 patients (90%) had postoperative radiotherapy and 18 patients (35%) developed distant metastasis. At last contact, 14 patients (27%) had died of disease (median follow-up=60 months). The 5-year and 10-year DSS rates for patients who had eye-sparing surgery (87.1% and 76.2%, respectively) were better than for patients who had orbital exenteration (62.3% and 57.5%, respectively, p=0.049). There was a significant difference between the DSS for basaloid (solid) versus non-basaloid histologic subtypes with a worse survival for basaloid histology (p=0.00057). Conclusions Pain was present in only one-third of patients with LGACC. The 5-year and 10-year DSS and OS rates are better than previously reported ‘historic data’. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"35 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911197","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":"Impact of a laminar air flow portable device on post-intravitreal injection endophthalmitis rate","authors":"Matteo Airaldi, Salvatore Parrulli, Andrea Trinco, Federico Cinus, Giovanni Staurenghi, Marco Pellegrini, Matteo Cereda","doi":"10.1136/bjo-2025-327316","DOIUrl":"https://doi.org/10.1136/bjo-2025-327316","url":null,"abstract":"Intravitreal injections (IVIs) are the most common outpatient procedure worldwide, yet no consensus exists regarding their optimal setting. This study analysed 101 976 IVIs performed between 2017 and 2023, comparing endophthalmitis rates before and after introducing a mobile laminar air flow (LAF) device in a clean room. The incidence of endophthalmitis decreased from 0.033% to 0.013%, a 63.2% risk reduction (Odds Ratio=0.368, p=0.04). These findings suggest that mobile LAF enhances air quality and reduces infection risk, offering a cost-effective, efficient alternative to operating theatres for IVIs.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"35 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911198","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":"From visual question answering to intelligent AI agents in ophthalmology","authors":"Xiaolan Chen, Ruoyu Chen, Pusheng Xu, Xiaojie Wan, Weiyi Zhang, Bingjie Yan, Xianwen Shang, Mingguang He, Danli Shi","doi":"10.1136/bjo-2024-326097","DOIUrl":"https://doi.org/10.1136/bjo-2024-326097","url":null,"abstract":"Ophthalmic practice involves the integration of diverse clinical data and interactive decision-making, posing challenges for traditional artificial intelligence (AI) systems. Visual question answering (VQA) addresses this by combining computer vision and natural language processing to interpret medical images through user-driven queries. Evolving from VQA, multimodal AI agents enable continuous dialogue, tool use and context-aware clinical decision support. This review explores recent developments in ophthalmic conversational AI, spanning theoretical advances and practical implementations. We highlight the transformative role of large language models (LLMs) in improving reasoning, adaptability and task execution. However, key obstacles remain, including limited multimodal datasets, absence of standardised evaluation protocols, and challenges in clinical integration. We outline these limitations and propose future research directions to support the development of robust, LLM-driven AI systems. Realising their full potential will depend on close collaboration between AI researchers and the ophthalmic community.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"22 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911193","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}