British Journal of Ophthalmology最新文献

{"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}

{"title":"Evaluation of visual function and OCT parameters in ethambutol-induced optic neuropathy: a longitudinal study","authors":"Gaurav Sachdeva, Rebika Dhiman, Dharam Raj, Gandepalli Lavanya, Anant Mohan, Amar Pujari, Swati Phuljhele, Rohit Saxena","doi":"10.1136/bjo-2025-327475","DOIUrl":"https://doi.org/10.1136/bjo-2025-327475","url":null,"abstract":"Aims To evaluate structural and visual functional parameters in ethambutol-related toxic optic neuropathy (EON). Methods In this prospective study, we recruited 95 adults with EON presenting within 1 month of onset and 100 age-matched healthy controls. Best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study chart), colour vision (Ishihara pseudoisochromatic plates), contrast sensitivity (Pelli-Robson chart), Humphrey visual field analysis (HVF 30–2 Swedish Interactive Threshold Algorithm-FAST), visual evoked response and spectral domain optical coherence tomography for macular ganglion cell-inner plexiform layer (mGC-IPL), retinal nerve fibre layer (RNFL) and papillomacular bundle (PMB) analyses were done at baseline, 3 months and 6 months. Results Almost 52% eyes showed significant visual improvement of ≥ 2 Snellen lines after stopping the drug. RNFL (cases-100.84±21.87 µm vs controls-98.05±7.21 µm; p=0.37) and PMB thickness (cases-51.10±17.26 µm vs controls-53.45±6.42 µm; p=0.19) in cases were comparable with controls at baseline, but showed significant thinning at 6 months follow-up (RNFL −83.77±21.06 µm; PMB-30.96±11.02 µm; p<0.0001 for both). Average GC-IPL thickness (cases-29.66±6.86 µm; controls-39.68±2.59 µm) and ganglion cell-inner plexiform layer (GCL) volume (cases-0.85±0.17 mm3; controls-1.08±0.069 mm3) was significantly less as compared with controls (p<0.0001 for all) at baseline and showed significant further deterioration on follow-up (p<0.001 for all). The average GC-IPL thickness (p value :<0.0001, r:−0.31), GCL volume (p value :<0.000, r:−0.29) and PMB thickness (p value :0.043, r:−0.14) showed a significant negative correlation with final vision at 6 months. Conclusion Progressive structural damage despite visual improvement raises concern about the irreversible nature of EON. PMB, GC-IPL thickness and GCL volume are better predictors of visual recovery in EON. Data are available in a public, open access repository. Not applicable.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899218","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 between building density and screening myopia in children and adolescents: a 5-year longitudinal study from China","authors":"Jingjing Wang, Jun Chen, Wei Gong, Yating Yang, Fengge Wang, Jinliuxing Yang, Linlin Du, Yuchen Du, Sichen Liu, Bo Zhang, Ling Wang, Xun Xu, Xiangui He","doi":"10.1136/bjo-2025-327439","DOIUrl":"https://doi.org/10.1136/bjo-2025-327439","url":null,"abstract":"Background This study explored the relationship between school-level built environment factors (building density and height) and myopia prevalence. Methods In all 16 districts of Shanghai, students from public schools and kindergartens underwent visual acuity testing and non-cycloplegic refraction between 2019 and 2023. Building density and height within 500-metre and 1,000-metre buffers around the schools were obtained using GIS (Geographic Information System)-based spatial and network analyses from the Tianditu database. Demographic and behavioural covariates, such as age, gender, outdoor activity time and near-work time, were collected through questionnaires. Logistic mixed-effect models were used to analyse the association between the building environment and myopia, adjusting for relevant demographic and behavioural factors. Results Data from 8 647 375 participants were analysed, with 1 116 851 followed consistently. The myopia rate among students was significantly higher during 2020–2021 compared with 2019, 2022 and 2023 (p<0.05). Myopia was more prevalent in students aged 6 to 12, with a higher average age for myopic individuals (8.13 vs 6.64 years). The average building density was higher at schools of myopic students (15.70%) versus non-myopic students (14.90%) (p<0.001). Building density near schools was negatively correlated with spherical equivalent (p<0.05), while no significant association was found with building height. The risk of myopia increased with higher building density (OR: 1.143–1.202, p<0.05), particularly in boys over 12 years old. A stronger association was observed in inner suburban areas (p<0.001). Conclusions Prolonged exposure to high building density may accelerate myopia progression. Urban planning should consider vision health, with regulations on building density near schools to reduce myopia risk. Data are available upon reasonable request. After publication of this study, study protocols, statistical code and requested questionnaire data may be made available to interested investigators after approval of Shanghai eye disease prevention and treatment centre. NDVI data can be modelled from Landsat satellite data. Linked electronic eye health records require separate permission from the Shanghai Municipal Health Commission.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"15 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899315","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":"Epidemiology of pathologic myopia in UK adults with high myopia","authors":"Fabian Yii, Niall Strang, Miguel O Bernabeu, Baljean Dhillon, Tom MacGillivray, Ian J C MacCormick","doi":"10.1136/bjo-2024-326889","DOIUrl":"https://doi.org/10.1136/bjo-2024-326889","url":null,"abstract":"Aims To conduct the first cross-sectional epidemiological investigation of pathologic myopia (PM) in UK adults with high myopia. Methods Fundus photographs of 3024 highly myopic eyes (spherical equivalent refraction (SER) ≤−5.00D) from 2000 randomly sampled adults (aged 40–70 years) in the UK Biobank were double graded by an ophthalmic reading centre using the Meta-analysis for Pathologic Myopia framework. Adjudication was performed by one of two retinal specialists. Multivariable mixed-effects logistic regression was used to explore potential risk factors and fundus biomarkers—initially adjusting for SER, age and sex, before including these and other variables with p<0.10 in a single model. Results PM was present in 1138 of 3006 gradable fundus photographs, with 41.7% (95% CI 39.5% to 43.9%) of participants affected in at least one eye graded. Most eyes with PM exhibited diffuse chorioretinal atrophy (97.4%), while the more severe stages—patchy chorioretinal atrophy and macular atrophy—were observed in only 24 and 5 eyes, respectively. 13 eyes had ‘plus’ lesions or suspected staphyloma. Factors independently associated with increased odds of PM (all p<0.05) included decreasing SER (adjusted OR: 0.22, 95% CI 0.15 to 0.32), older age (2.20, 1.63 to 2.97), female sex (1.87, 1.12 to 3.12), lower deprivation (0.73, 0.56 to 0.94), white ethnicity (52.3, 17.3 to 158.3), lower retinal arteriovenous ratio (0.47, 0.37 to 0.58), increased retinal vascular complexity (4.68, 3.22 to 6.81) and a relatively horizontal disc orientation (2.98, 1.88 to 4.72). None of the explored modifiable lifestyle or health-related variables were associated with PM. Conclusions PM prevalence is high among mid-life adults with high myopia in the UK Biobank, although most cases are relatively mild (diffuse chorioretinal atrophy). The only modifiable risk factor identified is myopia severity. Data may be obtained from a third party and are not publicly available. This research was conducted using data from the UK Biobank under project ID 90655. Bona fide researchers can apply for access at <https://www.ukbiobank.ac.uk/enable-your-research/apply-for-access>. The source code for all analyses described herein is openly available at [github.com/fyii200/UKbiobankPM][1]. [1]: https://github.com/fyii200/UKbiobankPM","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"15 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899219","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":"Corneal multifocality after penetrating keratoplasty or deep anterior lamellar keratoplasty is associated with intraocular lens power calculation error","authors":"Yuki Shiraishi, Enchi K Chang, Yukari Yagi-Yaguchi, Yuma Kayama, Yuki Kusano, Daisuke Tomida, So Goto, Tjundewo Lawu, Vishal Jhanji, Takefumi Yamaguchi","doi":"10.1136/bjo-2025-327868","DOIUrl":"https://doi.org/10.1136/bjo-2025-327868","url":null,"abstract":"Aim The purpose of this study is to investigate the accuracy of intraocular lens (IOL) power calculation after penetrating keratoplasty (PK) or deep anterior lamellar keratoplasty (DALK) and to identify the causes of predictive errors (PEs) in relation to the subjective keratometric (K) value (SK) in eyes with corneal multifocality. Methods This retrospective study included 74 eyes that underwent cataract surgery after PK or DALK. PEs were compared between SRK/T, Haigis, Barrett Universal II (BUII) and Kane formulas. In 27 eyes with postoperative anterior segment optical coherence tomography (AS-OCT) data, SKs were calculated based on postoperative refraction, IOL position, IOL power and axial length using Zemax. This was compared with K values obtained using AS-OCT. Results Mean absolute PE was 1.50±1.60 dioptre in SRK/T, 1.96±1.80 in Haigis, 1.84±1.71 in BUII and 1.83±1.86 in Kane. SK was significantly correlated with true K (TK) (r=0.86, p<0.001). The difference between SK and TK showed a significant correlation with PE in SRK/T (r=0.53, p=0.001). The PE in SRK/T was modelled as a function of the change in preoperative and postoperative K values as well as the difference between TK and SK, with significant improvement in the PE after factoring in these parameters. Conclusions Multifocal corneas, such as those after PK or DALK, may have SK values that differ significantly from K values obtained from AS-OCT. Therefore, traditional IOL formulas that use standard K values may lead to a refractive surprise after cataract surgery. Data are available upon reasonable request. The data that support the findings of this study are available on request. The data are not publicly available due to them containing information that could compromise research participant privacy/consent.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"22 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899221","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":"Effectiveness of artificial intelligence-based diabetic retinopathy screening in primary care and endocrinology settings in Australia: a pragmatic trial","authors":"Sanil Joseph, Yueye Wang, Jocelyn J Drinkwater, Catherine Lingxue Jan, Balagiri Sundar, Zhuoting Zhu, Xianwen Shang, Jacqueline Henwood, Katerina Kiburg, Malcolm Clark, Richard J MacIsaac, Angus W Turner, Peter Van Wijngaarden, Thulasiraj D Ravilla, Ming Guang He","doi":"10.1136/bjo-2025-327447","DOIUrl":"https://doi.org/10.1136/bjo-2025-327447","url":null,"abstract":"Purpose To investigate the diagnostic accuracy, feasibility and end-user experiences of an artificial intelligence (AI)-based, automated diabetic retinopathy (DR) screening model in real-world, Australian primary care and endocrinology clinics. Methods In a pragmatic trial conducted across five sites including general practice and endocrinology clinics, from August 2021 to June 2023, patients aged ≥50 years, and those aged ≥18 years with diabetes were screened using an AI-integrated, non-mydriatic fundus camera. The AI instantly analysed the retinal images for referable DR. Patients detected with referable DR or ungradable images were referred to eyecare professionals. The accuracy of the AI grading was assessed against gold standard human grading. A satisfaction survey was administered among the participants and care providers. Results Among 863 participants enrolled (mean (SD) age: 62.6 (13.2) years; 53.0% women), the AI system achieved high accuracy of 93.3% (95% CI: 91.4% to 95.5%) for referable DR detection, with a sensitivity of 83.7% (95% CI: 78.2% to 88.3%), specificity of 96.1% (95% CI: 94.7% to 97.2%) and an area under the receiver operating characteristic curve of 0.899 (95% CI: 0.874 to 0.924). The proportion of ungradable images was lower according to the AI grading (13.4%) compared with human grading (15.6%). Most patients (86%) and care providers (85%) expressed high satisfaction with the AI system. Conclusions The AI-assisted DR screening model was accurate and well received by patients and staff in Australian primary care and endocrinology clinics. This opportunistic screening model holds promise for enhancing early DR detection in non-eyecare settings, potentially preventing vision loss due to DR on a considerable scale. Data are available on reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"50 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899222","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":"High-sensitivity C-reactive protein and risk of retinal artery occlusion and ischaemic stroke: a cross-cohort study.","authors":"Yaxin Wang, Xiayin Zhang, Anyi Liang, Yongyi Niu, Daiyu Chen, Zijing Du, Wei Wu, Feng Zhang, Guanrong Wu, Ying Fang, Xianwen Shang, Zhuoting Zhu, Yijun Hu, Xiangjun Chen, Honghua Yu, Lidan Hu","doi":"10.1136/bjo-2023-325044","DOIUrl":"10.1136/bjo-2023-325044","url":null,"abstract":"<p><strong>Aims: </strong>Previous studies have suggested an association between retinal artery occlusion (RAO) and ischaemic stroke (IS), both associated with elevated inflammatory factors. However, the role of high-sensitivity C-reactive protein (hs-CRP) in the sequential onset of these two diseases is still unclear. Based on this evidence, we evaluated the association of hs-CRP with RAO and IS.</p><p><strong>Methods: </strong>We examined hs-CRP from both the large multicentre cohort study UK Biobank and Chinese Retinal Artery Occlusion study. Cox proportional hazard models were used to study the association of hs-CRP with incident RAO and IS during the long-term follow-up in the UK Biobank. Logistic regression analysis was employed to assess the cross-sectional relationship between hs-CRP with RAO and IS in the Chinese cohort. A restricted cubic spline (RCS) approach was employed to evaluate potential non-linear associations of hs-CRP with IS.</p><p><strong>Results: </strong>After exclusions, the analysis included 459 188 participants from the UK and 338 participants from China. Over a median follow-up of 12.2 years, 136 cases of incident RAO and 3206 cases of incident IS events were recorded in the UK Biobank. After multivariable adjustment, higher hs-CRP (per 10 mg/L) level was associated with increased risks of RAO (HR: 1.34, 95% CI: 1.01 to 1.76) and IS (HR: 1.24, 95% CI: 1.17 to 1.33). RCS analysis revealed a significant non-linear relationship between hs-CRP levels and incident IS (P_non-linear<0.001). Furthermore, RAO patients with higher hs-CRP levels were more likely to be combined with IS (2.81 mg/L vs 10.14 mg/L, p<0.001). In the Chinese cohort, the association between hs-CRP with RAO and IS was further confirmed. Higher hs-CRP (per 1 mg/L) level was associated with increased risks of RAO (OR: 1.43, 95% CI: 1.15 to 1.78) and IS (OR: 1.13, 95% CI: 1.03 to 1.24).</p><p><strong>Conclusions: </strong>Our findings underscore hs-CRP as a robust risk factor for both RAO and IS. Controlling hs-CRP levels might reduce the incidence of RAO and secondary stroke.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1081-1087"},"PeriodicalIF":3.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188375","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}