British Journal of Ophthalmology最新文献

{"title":"Reproducibility of consecutive automated telemetric noctodiurnal IOP profiles as determined by an intraocular implant.","authors":"Jacqueline J O N van den Bosch, Vincenzo Pennisi, Harsha Laxmana Rao, Kaweh Mansouri, Robert Weinreb, Hagen Thieme, Michael B Hoffmann, Lars Choritz","doi":"10.1136/bjo-2022-323080","DOIUrl":"10.1136/bjo-2022-323080","url":null,"abstract":"<p><strong>Background: </strong>Intraocular pressure (IOP) monitoring in glaucoma management is evolving with novel devices. We investigated the reproducibility of 24 hour profiles on two consecutive days and after 30 days of self-measurements via telemetric IOP monitoring.</p><p><strong>Methods: </strong>Seven primary patients with open-angle glaucoma previously implanted with a telemetric IOP sensor in one eye underwent automatic measurements throughout 24 hours on two consecutive days ('day 1' and 'day 2'). Patients wore an antenna adjacent to the study eye connected to a reader device to record IOP every 5 min. Also, self-measurements in six of seven patients were collected for a period of 30 days. Analysis included calculation of hourly averages to correlate time-pairs of day 1 versus day 2 and the self-measurements vers day 2.</p><p><strong>Results: </strong>The number of IOP measurements per patient ranged between 151 and 268 on day 1, 175 and 268 on day 2 and 19 and 1236 during 30 days of self-measurements. IOP time-pairs of automatic measurements on day 1 and day 2 were significantly correlated at the group level (R=0.83, p<0.001) and in four individual patients (1, 2, 6 and 7). IOP time-pairs of self-measurements and day 2 were significantly correlated at the group level (R=0.4, p<0.001) and in four individual patients (2, 5, 6 and 7).</p><p><strong>Conclusions: </strong>Twenty-four hour automatic measurements of IOP are correlated on consecutive days and, though to a lesser degree, with self-measurements. Therefore a virtual 24-hour IOP curve might be constructed from self-measurements. Both options provide an alternative to frequent in-office IOP measurements.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of glued (sutureless) amniotic membrane transplantation in acute Stevens-Johnson syndrome/toxic epidermal necrolysis: a comparative study.","authors":"Ramy Rashad, James T Kwan, Swapna S Shanbhag, Panotsom Ngowyutagon, Musa Saeed, Mohammad A Tahboub, Abid Haseeb, James Chodosh, Hajirah N Saeed","doi":"10.1136/bjo-2023-324076","DOIUrl":"10.1136/bjo-2023-324076","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effectiveness and efficiency of a glued (sutureless) technique for amniotic membrane transplantation (AMT) with a traditional sutured one in the setting of acute Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN).</p><p><strong>Methods: </strong>This retrospective cohort study evaluated all patients diagnosed with SJS/TEN between 2008 and 2020 within our hospital network who received AMT in the acute phase according to our protocol and had at least one ophthalmic follow-up in the chronic phase. Primary outcomes included best-corrected visual acuity (BCVA) at the most recent visit, presence of a severe ocular complication (SOC) via predefined criteria, time to procedure and duration of procedure. Random effects model analysis was used to evaluate the impact of potential covariates on outcome measures.</p><p><strong>Results: </strong>A total of 23 patients (45 eyes) were included: 14 patients (27 eyes) in the AMT suture group and 9 patients (18 eyes) in the AMT glue group. There was no difference between the two groups in BCVA at the most recent visit (p=0.5112) or development of a SOC (p=1.000). The glue method was shorter in duration than the suture method (p<0.001). Random effects model additionally indicated that there was no difference in BCVA at most recent follow-up between patients who had received glued versus sutured AMT (p=0.1460).</p><p><strong>Conclusions: </strong>Our glued technique for AMT is as effective as our sutured technique in stabilising the ocular surface and mitigating chronic ocular complications in SJS/TEN. The glued technique is also shorter in duration and performed more expediently than the sutured technique.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140136517","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":"Ocular findings in patients with histiocytosis and association with clinical and molecular features.","authors":"Jasmine H Francis, Anne S Reiner, Julia Canestraro, Raajit K Rampal, David H Abramson, Eli L Diamond","doi":"10.1136/bjo-2023-324877","DOIUrl":"10.1136/bjo-2023-324877","url":null,"abstract":"<p><strong>Background/aims: </strong>Ocular manifestations of histiocytosis and their genetic underpinnings are poorly characterised. This study characterises ocular sites of histiocytosis, notate genetic alterations and correlates to histiocytosis clinical features including subtype and sites of disease.</p><p><strong>Methods: </strong>Prospective registry-based study of predominantly adult histiocytosis patients at a single-institution tertiary referral centre. 180 eyes of 90 patients (46 males, 44 females) with histiocytosis (Erdheim-Chester disease 34, Rosai-Dorfman 20, xanthogranuloma 7, mixed histiocytosis 13, Langerhans cell histiocytosis (LCH) 15, ALK-positive histiocytosis 1). Ocular findings were categorised by the structure involved. Histiocytosis subtype, sites of disease and genetic status were correlated to ocular findings.</p><p><strong>Results: </strong>Ocular disease was present in more than half the histiocytosis patient cohort and occurred with other disease sites. Ocular findings were statistically significantly different across histiocytic subtypes with LCH subtypes having the lowest proportion of ocular findings (7%) and all other subtypes having rates of ocular findings which were five times that of patients with LCH (p=0.0009). Of patients with ocular findings, 41% of patients reported ocular symptoms and were significantly more in the group with ocular disease present versus those patients without ocular involvement. The presence of ocular findings was not statistically different by <i>BRAF</i>V600E, <i>MAP2K1</i> or <i>RAS</i> isoform mutational status.</p><p><strong>Conclusions: </strong>Ocular disease is a common feature of histiocytosis with significant visual symptomatology and occurrence in tandem with multisystem sites. Ocular findings vary by histiocytic subtype. The mutational profile of the cohort reflects known mutations in this clinical population, with no specific driver mutation associated with ocular disease.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092856","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":"Global burden of vaccine-associated uveitis and their related vaccines, 1967–2023","authors":"Jiyeon Oh, Seoyoung Park, Jaeyu Park, Hyesu Jo, Hayeon Lee, Raphael Udeh, Masoud Rahmati, Jee Myung Yang, Joo Yong Lee, Dong Keon Yon","doi":"10.1136/bjo-2024-325985","DOIUrl":"https://doi.org/10.1136/bjo-2024-325985","url":null,"abstract":"Although uveitis after vaccination is rare, reports emerged during the COVID-19 pandemic. We used the pharmacovigilance case/non-case study from 1967 to 2023 to assess the association between vaccines and uveitis. We identified a significant signal for uveitis (reporting OR (ROR), 1.64; information component (IC)025, 0.66) with 1508 reports. This association is pronounced in females of all ages after childhood. Specifically, the COVID-19 messenger RNA vaccines showed the strongest disproportionality signal (ROR, 5.76; IC025, 2.33), followed by hepatitis B, papillomavirus, Ad (Adenovirus) 5-vectored COVID-19 and influenza vaccines. These findings underscore the importance of surveillance in the postmarketing phase to manage potential adverse events associated with vaccine administration. The data are available upon request. Study protocol and statistical code: Available from DKY (yonkkang@gmail.com). Data set: Available from the Uppsala Monitoring Centre or WHO through a data use agreement.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142449473","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 polymorphisms in the HTRA1 gene with myopia","authors":"Shu Ying Chen, You Mei Xu, Pancy O S Tam, Chi Pui Pang, Clement C Tham, Jason C Yam, Li Jia Chen","doi":"10.1136/bjo-2024-325935","DOIUrl":"https://doi.org/10.1136/bjo-2024-325935","url":null,"abstract":"Purpose To evaluate the associations of single-nucleotide polymorphisms (SNPs) in the high-temperature requirement protease A 1 ( HTRA1) gene with myopia. Methods 25 SNPs in HTRA1 were selected, including 23 haplotype-tagging SNPs, SNP rs2142308 from a previous genome-wide association study (GWAS) of myopia and rs11200638, a SNP strongly associated with age-related macular degeneration (AMD). All SNPs were genotyped in a Hong Kong Chinese cohort of 533 myopia subjects (including 175 high myopia, 189 moderate myopia and 189 mild myopia) and 280 non-myopic controls. The association of individual SNPs were evaluated in overall myopia and different subgroups of myopia using logistic regression. Results A tagging SNP, rs11200647, was significantly associated with myopia (p=2.17×10-4, OR=0.67). Nominal associations were detected for the AMD-associated SNP rs11200638 (p=0.0042, OR=1.37) and tagging SNPs rs12266322 (p=0.0048, OR=0.59) and rs17103569 (p=0.047, OR=1.34). The association of rs11200647 with myopia remained significant after adjusting for rs11200638, rs12266322 and rs17103569. In sub-group analysis, two tagging SNPs, rs11200647 (p=2.24×10-4, OR=0.58) and rs12266322 (p=8.31×10-4, OR=0.39), showed significant association with moderate myopia. In haplotype association analysis, haplotypes AT (p=1.00×10-4, OR=1.77) and haplotype GT (p=0.0019, OR=0.64), defined by rs11200647 and rs66884382, were significantly associated with myopia. Conclusions This study provided new evidence to support HTRA1 as an associated gene for myopia, especially moderate myopia. The findings suggested that myopia and AMD may have shared genetic components. 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":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440212","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":"Analysis of factors influencing refractive error in Fuchs eyes undergoing Descemet membrane endothelial keratoplasty triple procedure.","authors":"Jenny Chun Ling Kuo,Kyong Jin Cho,Muhammad Ali,Albert S Jun,John G Ladas,Divya Srikumaran","doi":"10.1136/bjo-2024-325967","DOIUrl":"https://doi.org/10.1136/bjo-2024-325967","url":null,"abstract":"PURPOSETo evaluate the accuracy of current intraocular lens (IOL) formulas and identify factors influencing mean error in eyes undergoing Descemet membrane endothelial keratoplasty (DMEK) triple procedure, that is, DMEK combined with cataract extraction and IOL placement for concurrent Fuchs endothelial corneal dystrophy (FECD) and cataracts.DESIGNRetrospective cohort study.SUBJECTS90 eyes with FECD undergoing uncomplicated DMEK triple procedure at Wilmer Eye Institute.METHODSWe analysed tomographic features of oedema, including loss of regular isopachs, displacement of the thinnest point of the cornea and the presence of posterior surface depression, and assessed the correlation with the prediction error.MAIN OUTCOME MEASURESWe compared the mean error (±SD) for the Barrett Universal II (BU2), Hoffer QST, Haigis-L (HL) and Barrett True K (BTK) formulas and the percentage of eyes within 0.25, 0.5 and 1 diopter (D) of error.RESULTSAll formulas resulted in a mean hyperopic error, with the HL having the lowest mean error of 0.24 D (±0.97 D) and BU2 having the highest ME of 0.94 D (±0.97 D). For each additional tomographic feature of corneal oedema in the BU2 and Hoffer QST formulas, the mean hyperopic error increased by 0.38 D. For the BTK and HL formulas, the mean error increased by 0.35 D (p<0.001).CONCLUSIONThe number of tomographic features of oedema can be useful in identifying eyes with higher errors in IOL calculation when performing the DMEK triple procedure for FECD.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439249","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":"Novel diagnostic method for B cell vitreoretinal lymphoma by identification of regulatory T cells and PD-1+ cytotoxic T lymphocytes in the vitreous via flow cytometry.","authors":"Hideto Deguchi,Kenji Nagata,Tohru Inaba,Takanori Aoki,Hikaru Kitano,Chie Sotozono","doi":"10.1136/bjo-2024-326240","DOIUrl":"https://doi.org/10.1136/bjo-2024-326240","url":null,"abstract":"AIMSTo investigate the significance of regulatory T cells (Tregs) and programmed cell death 1 (PD-1)+ cytotoxic T lymphocytes (CTLs) in the vitreous of patients with vitreoretinal lymphoma (VRL) and uveitis.METHODSThis study involved 51 patients with VRL and uveitis, 15 males and 36 females (mean age: 72 years, range: 51-86 years), who underwent vitrectomy at the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan, from December 2019 to February 2024. All patients underwent lymphocyte surface antigen analysis via flow cytometry, and the proportion of Tregs in CD4+ T lymphocytes and PD-1+ CTLs in CD8+ T lymphocytes was measured.RESULTSThis study involved B cell VRL (B-VRL, n=16), sarcoidosis (n=8), human herpesvirus (HHV)-associated uveitis (n=7), human T cell lymphotropic virus type 1 associated uveitis (HAU, n=3) and unclassifiable uveitis (n=17) cases. The median proportions of Tregs were significantly lower in B-VRL (2.2%) compared with sarcoidosis (8.5%), HHV-associated uveitis (16.4%) and unclassifiable uveitis (10.1%) (p<0.05). Conversely, a significantly higher proportion of PD-1+ CTLs was found in B-VRL (95.6%) compared with sarcoidosis (61.1%), HHV-associated uveitis (67.1%) and unclassifiable (64.8%) (p<0.05). Receiver operating characteristic analysis of Tregs and PD-1+ CTLs proportions in B-VRL revealed high area under the curve values of 0.913 and 0.940, respectively.CONCLUSIONSOur findings indicate that analysis of the ratio of Tregs and PD-1+ CTLs via flow cytometry is helpful in diagnosing B-VRL.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439495","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":"Vitreoretinal lymphoma: the importance of cerebral spinal fluid evaluation at initial diagnosis","authors":"Rebecca F Silverman, David H Abramson, Julia Canestraro, Christian Grommes, Jasmine H Francis","doi":"10.1136/bjo-2024-325999","DOIUrl":"https://doi.org/10.1136/bjo-2024-325999","url":null,"abstract":"Background/aims To determine if patients with vitreoretinal lymphoma (VRL) and concomitant central nervous system lymphoma (CNSL) may present without brain MRI findings, but possess cerebrospinal fluid (CSF) suspicious for lymphoma. Methods This was a retrospective, single-centre, observational study evaluating patients with a diagnosis or suspicion of VRL seen at Memorial Sloan Kettering Cancer Center between 2006 and 2024. Patients were included if the final diagnosis was biopsy-proven CNSL and both MRI brain with and without contrast±CSF evaluation (obligatory for inclusion if MRI negative) were performed at the initial diagnostic workup. Patients were excluded if CNS disease treatment (brain, spine or CSF) preceded ocular disease. Patients with prior extra-CNS disease were included. Clinical records and radiographic imaging were retrospectively reviewed and relevant data were recorded for each patient. We evaluated the proportion of patients with MRI negative and CSF suspicious for lymphoma. Subgroup analysis included imaging features, pathology, treatment and disease course. Results We identified 65 patients. Of the 65 patients at the presentation of VRL, 30 had negative MRI brain and CSF, 16 had positive brain MRI and negative CSF and 8 had both positive MRI brain and CSF. 11 (16.9%) had CSF suspicious for lymphoma without positive findings on MRI of the brain. In this subgroup, the median age was 66 years (range 49–82) and 36% were female. 86% of these patients were asymptomatic neurologically. 73% underwent systemic treatment. At a mean 3 years follow-up, 91% of patients were living. Conclusion In patients with suspected VRL, it is possible to have CSF test positive for lymphoma in the context of negative brain MRI. This suggests, when evaluating VRL patients for concomitant CNS disease, CSF evaluation leads to earlier detection and systemic treatment, even when MRI brain findings are negative. In our cohort, an absence of CSF evaluation in the context of negative brain MRI could have missed 16.9% of patients with CNS lymphoma. All data relevant to the study are included in the article or uploaded as online supplemental information.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142385538","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 surgical outcomes and prognostic factors for advanced-stage retinopathy of prematurity after vitrectomy","authors":"Yin-Hsi Chang, Eugene Yu-Chuan Kang, Kuan-Jen Chen, Nan-Kai Wang, Laura Liu, Yih-Shiou Hwang, Chi-Chun Lai, Wei-Chi Wu","doi":"10.1136/bjo-2023-323723","DOIUrl":"https://doi.org/10.1136/bjo-2023-323723","url":null,"abstract":"Background/aims The aims of this study is to evaluate the anatomic, visual outcomes and associated prognostic factors in patients with advanced retinopathy of prematurity (ROP) following vitrectomy. Methods A retrospective cohort study of patients with ROP who underwent vitrectomy from 2005 to 2016 was conducted. All the patients had a follow-up period of at least 5 years. Univariate and multivariable logistic regression analyses were used to explore the factors related to unfavourable outcomes. Results In total, 81 eyes of 51 patients were included. The mean age at last follow-up was 10.2 years. The anatomic success rate was 96.3% (26/27) for stage 4A, 90.9% (20/22) for stage 4B and 31.3% (10/32) for stage 5 ROP (p<0.01). The mean logMAR best corrected visual acuity of the stage-4A eyes was the highest, followed by those of stage-4B and stage-5 eyes (0.8, 1.5 and 2.6 for stages 4A, 4B and 5, respectively; p<0.01). High myopia (≤ −5.0 D) was noted in 70.8% and 71.4% of stage-4A and stage-4B eyes, respectively. Cataract was the most common complication (25.9%), followed by corneal opacity (17.3%), strabismus (16.1%), and phthisis (16.1%). Stage of the disease was a poor prognostic factor in all vitrectomised eyes (p<0.01). Vitrectomy combined lensectomy was a significant predictor for poor anatomic outcomes for stage-4 eyes (p=0.03). Presence of plus disease was also a possible factor affecting the surgical outcomes. Conclusion The long-term surgical outcomes of the eyes with stage 4A and 4B ROP were favourable. Management of stage 5 ROP remained challenging. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142384146","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":"Paediatric staphyloma classification: new perspectives via ultrawide field three-dimensional swept-source optical coherence tomographic angiography","authors":"Limei Sun, Aohan Hou, Shuxin Zheng, Linyan Zhang, Lu Qin, Xiaoyan Ding","doi":"10.1136/bjo-2023-324793","DOIUrl":"https://doi.org/10.1136/bjo-2023-324793","url":null,"abstract":"Aim To employ ultrawide field three-dimensional swept-source optical coherence tomographic angiography (UWF 3D SS-OCTA) modality, integrating novel strategies, posterior eye curvature maps and posterior eye height maps, in characterising the features and disease associations of posterior staphyloma in paediatric patients. This study seeks to compare paediatric staphylomas to established adult classifications, identify distinct paediatric patterns and introduce a new classification system for paediatric staphyloma using advanced multimodal imaging. Methods UWF 3D SS-OCTA imaging, integrating posterior eye curvature maps and posterior eye height maps strategies, was employed to analyse staphyloma presentations in the paediatric cohort. These data were then set against the traditionally established adult classifications. Additionally, the aetiology of staphylomas was investigated. Results The UWF 3D SS-OCTA modality, when integrated with posterior eye curvature maps and posterior eye height map, showcased superior imaging detail and better classification compared with UWF scanning laser ophthalmoscope, offering a more nuanced view of staphyloma patterns in paediatric patients. Specifically, only 54.7% of the paediatric cohort fit into previously recognised categories. The paediatric group displayed prominent temporal and inferior temporal staphylomas, likely linked to the high prevalence of peripheral vascular diseases. The study led to the proposal of five unique paediatric staphyloma classifications. Conclusions The UWF 3D SS-OCTA modality with posterior eye curvature maps and posterior eye height maps offers unparalleled insights into staphyloma patterns, especially in paediatric patients. Paediatric staphylomas exhibit a unique presentation, divergent from adults, with two novel types identified. The findings underline the importance of updating classification systems, ensuring they reflect the realities observed in paediatric pathology and diagnostics. Data are available on reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142384152","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}