British Journal of Ophthalmology最新文献

{"title":"Management strategies in endogenous fungal endophthalmitis: a multi-institutional retrospective cohort study.","authors":"Eleanor Burton, Mohammed M Shahid, Wen Fan Hu, Elaine Hu, Krista Thompson, Jacob Aumeier, Jonathan Ji, Jennifer Cao, Sapna Gangaputra, Vishal Reddy, Kareem Moussa, Shelby Thomas, Lynn Hassman, Irmak Karaca, Akbar Shakoor, Hailey Robles-Holmes, Alexandria Marshall, Kishan Avaiya, Brian K Do, Arthi G Venkat","doi":"10.1136/bjo-2025-329157","DOIUrl":"https://doi.org/10.1136/bjo-2025-329157","url":null,"abstract":"<p><strong>Background/aims: </strong>Standardised treatment guidelines for endogenous fungal endophthalmitis (EFE) are lacking. The purpose of this study is to describe treatment strategies and clinical outcomes of eyes with EFE.</p><p><strong>Methods: </strong>Retrospective cohort study performed at eight academic institutions across the USA. Demographic, clinical and treatment data for patients with clinically or culture-proven EFE between 2010 and 2025 were included. Patients were stratified by route of systemic therapy for analysis.</p><p><strong>Results: </strong>A total of 118 eyes of 87 patients were included. Most patients were treated initially with intravenous systemic antifungal therapy (64%). Patients with systemic symptoms and systemic culture positivity and eyes with negative intraocular fluid cultures were more likely to be treated initially with intravenous systemic therapy. Voriconazole (34%) and fluconazole (30%) were the most used initial systemic agents. Eyes treated with intravenous antifungals were less likely to undergo surgery (intravenous 21% vs oral 50%, p=0.001), but this trend did not maintain statistical significance when controlling for confounders (OR 0.33 (95% CI 0.1 to 1.06), p=0.067). Worse presenting vision (OR 1.78, p<0.001) and infection with mould (OR 4.26, p<0.001) were associated with worse final vision. Ocular examination findings did not significantly affect the initial treatment route, the requirement for surgery or final vision.</p><p><strong>Conclusions: </strong>Patients with systemic disease were more likely to be treated initially with intravenous therapy, whereas ocular findings did not significantly influence initial systemic treatment strategy. Initial treatment with intravenous therapy may decrease the odds of requiring surgical intervention.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910806","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":"Education and myopia prevalence in children from kindergarten to primary school: an exploratory mediation analysis from the Hong Kong children eye study.","authors":"Yuzhou Zhang, Xiu Juan Zhang, Fen Fen Li, Benjamin H Yip, Mandy Ph Ng, Ka Wai Kam, Alvin L Young, Wei Zhang, Patrick Ip, Kathryn Rose, Ian Morgan, Clement C Tham, Li Jia Chen, Chi Pui Pang, Jason C Yam","doi":"10.1136/bjo-2025-327966","DOIUrl":"https://doi.org/10.1136/bjo-2025-327966","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the role of education on myopia prevalence and refractive status in children enrolled in kindergarten and the early grades of primary school.</p><p><strong>Methods: </strong>In this population-based, cross-sectional study, children from primary schools and kindergartens were recruited prior to the onset of the COVID-19 pandemic in January 2020. Cycloplegic autorefraction and axial length (AL) were measured in all children. Data on parental myopia, family income and children's lifestyle factors were collected via a standard questionnaire. Mediation analyses were used to explore the influence of education on myopia prevalence, spherical equivalent (SE) and AL.</p><p><strong>Results: </strong>In 2525 kindergarten children (413 in grade 2 /(K2) and 2112 in grade 3 (K3)) and 9018 primary school children (4250 in grade 1 (P1) and 4768 in grade 2 (P2)), myopia prevalence increased with academic grade: 7.6% of K2, 8.7% K3, 17.3% P1 and 29.1% P2. AL was longer in K3 than in K2 children (p<0.001) although SE did not differ (p=0.18). Exploratory analyses suggested statistical mediation by education duration in the association between age and myopia-related outcomes. Among kindergarten children, parental myopia was the sole factor associated with myopia prevalence, SE and AL. For primary school children, schooling duration in P1, age, sex, family income and parental myopia were associated with myopia prevalence, SE and AL.</p><p><strong>Conclusion: </strong>The prevalence of myopia significantly increased from kindergarten to primary school with education duration being a possible mediator from primary school onward. Notably, significant changes in AL were observed among kindergarten children.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891001","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 corneal endothelial cell loss after paediatric ocular trauma: a specular microscopy study.","authors":"Paula Basso Dias, Asim Ali, Sara Williams, Kamiar Mireskandari","doi":"10.1136/bjo-2026-330257","DOIUrl":"https://doi.org/10.1136/bjo-2026-330257","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate long-term corneal endothelial changes in children following ocular trauma and the influence of trauma type and surgical history.</p><p><strong>Methods: </strong>Prospective study that evaluated corneal endothelial parameters in a retrospectively identified cohort of 59 paediatric patients with unilateral trauma and bilateral specular microscopy ≥6 months after injury. Endothelial cell density (ECD), coefficient of variation (CV) and percentage of hexagonal cells (HEX) were compared between traumatised and fellow eyes. Subgroup analyses were performed according to trauma type (open vs closed globe) and surgical history.</p><p><strong>Results: </strong>59 children (mean age 7.3±3.6 years) were included, comprising 37 open-globe (OGI) and 22 closed-globe injuries (CGI). At a mean follow-up of 48.6±31.8 months, traumatised eyes exhibited significantly lower ECD (2528±633 vs. 3202±356 cells/mm²; p<0.01), higher CV (p<0.01) and lower HEX (p<0.01). Both OGI and CGI demonstrated significant endothelial loss relative to controls. Eyes that underwent additional intraocular surgery exhibited a 33.3% reduction in ECD compared with fellow eyes in OGI (p<0.01) and a 15.7% reduction in CGI (p=0.043). Even without additional intraocular surgery, ECD loss persisted in both OGI (15.7%; p<0.01) and CGI (7.6%; p=0.015).</p><p><strong>Conclusions: </strong>Paediatric ocular trauma was associated with lower endothelial cell density and morphologic alterations. Although endothelial compromise was observed across both OGI and CGI, the magnitude of loss was greater in OGI and in eyes requiring additional intraocular surgery. These findings highlight the importance of careful surgical planning to help preserve endothelial reserve in eyes with prior trauma.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891083","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":"False-positive patterns in optical coherence tomography in hyperopic and myopic eyes.","authors":"Se Hie Park, Young Kook Kim, Jin Wook Jeoung, Ki Ho Park","doi":"10.1136/bjo-2025-328340","DOIUrl":"https://doi.org/10.1136/bjo-2025-328340","url":null,"abstract":"<p><strong>Background/aims: </strong>This study aimed to evaluate how axial length influences false-positive rates in ganglion cell analysis (GCA) and retinal nerve fibre layer (RNFL) maps and to identify distinct false-positive patterns on optical coherence tomography (OCT) deviation maps across axial length subgroups.</p><p><strong>Methods: </strong>A retrospective cross-sectional study of 194 healthy eyes included spectral-domain OCT imaging. False positives were defined as colour-coded areas on GCA/RNFL maps. Eyes were stratified into three axial length groups: group A (<23 mm), group B (23 mm≤axial length<25 mm) and group C (≥25 mm). Abnormal OCT deviation map patterns were analysed and compared across axial length groups.</p><p><strong>Results: </strong>False-positive results were observed in 76.1% of cases for GCA and 62.2% for RNFL maps. Rates increased significantly with axial length: for GCA deviation maps, the rates were 45.2% in group A, 51.2% in group B and 87.5% in group C (p<0.001). The most frequent false-positive pattern in hyperopic eyes was the small doughnut type (67.9%), while diffuse thinning and inferior crescent patterns predominated in highly myopic eyes (both 38.1%). In logistic regression analysis, axial length was an independent predictor of false positives in all maps (OR 1.09-2.64, p<0.05). Older age also correlated with false positives (OR 1.04-1.06, p<0.05), except for minimum ganglion cell-inner plexiform layer thickness.</p><p><strong>Conclusion: </strong>Abnormal OCT diagnostic classification should be interpreted with caution, particularly in eyes with long axial length and in older patients. Distinctive patterns in the GCA deviation map are observable in patients with markedly short or long axial lengths, and recognising these false-positive patterns may prompt more cautious interpretation.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886505","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 globe-preserving therapies in unilateral cT2/cT3 retinoblastoma: a multicentre study of 1566 eyes.","authors":"Yiran Yao, Mingpeng Xu, Jie Yang, Yunhan Zhu, Yilin Yu, Minglei Han, Xiaoyu He, Zhenyu Xu, Yanping Han, Xinji Yang, Yishuang Xiao, Xian Wang, Yang-Jun Li, Li Wu, Jia Tan, Liwen Jin, Jing Zhang, Junyang Zhao, Xunda Ji, Peiwei Chai, Xuyang Wen, Jiayan Fan, Renbing Jia","doi":"10.1136/bjo-2026-330597","DOIUrl":"https://doi.org/10.1136/bjo-2026-330597","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate survival, globe salvage and visual outcomes of globe-preserving treatment approaches in unilateral cT2 and cT3 retinoblastoma, with a focus on cT3 disease.</p><p><strong>Methods: </strong>This multicentre, retrospective cohort study enrolled 1566 treatment-naïve unilateral retinoblastoma eyes (870 clinical (c)T2, 696 cT3 by eighth American Joint Committee on Cancer clinical tumour, node, metastases staging) from 11 Chinese tertiary centres. Patients underwent intra-arterial chemotherapy, intravenous chemotherapy or primary enucleation. Outcomes were globe salvage, overall survival, metastasis-free survival, high-risk histopathological feature prevalence and vision-preserving rate (≥light perception (LP)).</p><p><strong>Results: </strong>In this multicentre cohort of 1566 eyes, the globe-salvage rate across cT2 and cT3 retinoblastoma was higher with intra-arterial chemotherapy than with intravenous chemotherapy. When stratified by cT3 subcategories, intra-arterial chemotherapy achieved significantly higher globe-salvage rates than intravenous chemotherapy in cT3b eyes (HR 3.65; 95% CI 1.91 to 6.98) and cT3c eyes (HR 4.02; 95% CI 2.79 to 5.80). In contrast, globe salvage did not differ between intra-arterial chemotherapy and intravenous chemotherapy in cT3d eyes. Overall survival and metastasis-free survival did not differ between intra-arterial chemotherapy and primary enucleation. Among eyes with cT3b or cT3c disease, 79.4% of eyes salvaged with intra-arterial chemotherapy and 65.0% of eyes salvaged with intravenous chemotherapy retained at least LP. Detected high-risk pathological features were not significantly different between eyes treated with intra-arterial chemotherapy and those undergoing primary enucleation in cT3b or cT3c disease. Among secondary enucleated eyes with cT3d disease, intra-arterial chemotherapy was associated with lower rates of choroidal invasion.</p><p><strong>Conclusion: </strong>Intra-arterial chemotherapy may enable globe salvage in cT3b/c retinoblastoma, whereas cT3d eyes continue to warrant prompt enucleation.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872825","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":"Modular multi-task deep learning framework for prediction of treatment initiation in neovascular age-related macular degeneration modular AI for NVAMD treatment initiation study-MANTIS.","authors":"Qitong Gao, David Kuo, Joshua Amason, Terry Lee, Jay K Rathinavelu, Miroslav Pajic, Majda Hadziahmetovic","doi":"10.1136/bjo-2025-328327","DOIUrl":"10.1136/bjo-2025-328327","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to develop a fully automated system for determining the optimal time to begin anti-vascular endothelial growth factor (anti-VEGF) treatment, based on retinal changes observed in optical coherence tomography (OCT) images and visual acuity (VA) scores.</p><p><strong>Methods: </strong>This retrospective study included two cohorts: patients with intermediate dry age-related macular degeneration (AMD) who did not progress to neovascular AMD (NVAMD) and those who progressed and received anti-VEGF treatment. Subjects had ≥3 consecutive visits. Two tasks were defined: (1) develop a deep learning (DL) model to identify the need for anti-VEGF treatment and (2) estimate outer retina thickness (ORT) from Bruch's membrane to the outer plexiform layer as an imaging biomarker. A convolutional neural network extracted OCT features related to ORT, and two long short-term memory models were trained on separate datasets to address Task I and II treatments.</p><p><strong>Results: </strong>A total of 122 patients (207 eyes) were included: 49 in dataset 1 (69 eyes; mean (SD) age 84 (8); 25 (51%) female) and 100 in dataset 2 (138 eyes; 82 (7); 54 (54%) female). <i>Task I</i> performance was evaluated by the model's alignment with clinical decisions on anti-VEGF initiation, and demonstrated area under the receiver operating curve of 0.73 (95% CI 0.59 to 0.87), area under the precision-recall curve of 0.51 (95% CI 0.35 to 0.66), an accuracy of 0.87 (95% CI 0.76 to 0.97), a precision of 0.73 (95% CI 0.59 to 0.87), a sensitivity of 0.69 (95% CI 0.54 to 0.83) and a specificity of 0.92 (95% CI 0.84 to 1.00). <i>Task II</i> achieved NMAE 0.12 (95% CI 0.04 to 0.20).</p><p><strong>Conclusions: </strong>This DL framework provides a fully automated approach for determining optimal treatment timing, supporting earlier intervention to preserve VA in NVAMD patients.</p><p><strong>Transitional relevance: </strong>An accurate DL framework that can help with identifying the best time to initiate therapy for NVAMD.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872753","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":"Corneal radius-specific axial length/corneal radius ratio cut-offs for improved myopia detection in children: a population-based study.","authors":"Daixi Chen, Linlin Du, Jun Chen, Jingjing Wang, Haidong Zou, Xun Xu, Xiangui He, Wei Gao","doi":"10.1136/bjo-2026-329775","DOIUrl":"https://doi.org/10.1136/bjo-2026-329775","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate how corneal radius (CR) affects the optimal axial length-to-corneal radius (AL/CR) ratio cut-off for myopia detection and to construct a multivariable model for estimating myopia probability in children and adolescents.</p><p><strong>Methods: </strong>A total of 6782 children and adolescents aged 3-18 years from Shanghai, China, were included. Myopia was defined as a cycloplegic spherical equivalent (SE) less than or equal to -0.50 dioptres. Participants were stratified into six CR groups (0.25 mm intervals). Receiver operating characteristic curve analysis was used to determine optimal AL/CR cut-off values for each CR group. Linear regression was performed to model the relationship between CR and optimal cut-offs. A multivariable logistic regression model incorporating CR, AL/CR ratio, age and sex was fitted, and model-based estimates were summarised using contour plots and lookup tables.</p><p><strong>Results: </strong>Mean age was 9.36±3.59 years, and myopia prevalence was 33.8%. Optimal AL/CR cut-offs decreased with increasing CR, from 3.10 (7.08≤CR≤7.33 mm) to 2.93 (8.33<CR≤8.60 mm), with areas under the curve (AUCs) of 0.94-0.97 across groups. The optimal AL/CR cut-off was linearly associated with CR (optimal cut-off=4.073-0.135×CR; R²=0.948; p=0.001). The multivariable model showed high discrimination (AUC=0.97) in this dataset. Age- and sex-specific lookup tables and probability contour plots were generated to summarise model-based estimates.</p><p><strong>Conclusions: </strong>The optimal AL/CR ratio cut-off for myopia detection varies systematically with CR. These findings indicate that CR contributes to variation in AL/CR-based myopia classification. The fitted equation, probability contour plots and lookup tables provide CR-informed reference estimates for interpreting AL/CR in children and adolescents.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863605","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":"Aggressive retinopathy of prematurity: characteristics and risk factors for retreatment.","authors":"Jonathan Z Liu, Celine Chaaya, Nina Ahmad, Naira Ikram, Francisco Altamirano, Sandra Hoyek, Arthur Brant, Luis A Acaba-Berrocal, Kenneth C Fan, María Ana Martínez-Castellanos, Caroline R Baumal, Clio Armitage Harper, Audina M Berrocal, Nimesh A Patel","doi":"10.1136/bjo-2026-330184","DOIUrl":"https://doi.org/10.1136/bjo-2026-330184","url":null,"abstract":"<p><strong>Background/aims: </strong>Aggressive retinopathy of prematurity (A-ROP) is a severe subtype of ROP that can require repeated treatment yet risk factors for retreatment remain incompletely defined. This study aims to identify risk factors for anti-vascular endothelial growth factor (VEGF) re-injection in A-ROP across US-born and non-US-born infants.</p><p><strong>Methods: </strong>Data from premature infants with ROP were collected across 23 sites (16 USA, 7 non-USA) from 2007 to 2021. A-ROP re-injection risk was evaluated using generalised estimating equations, adjusted for birth weight (BW), gestational age (GA) at birth, ROP zone at injection, hospital site and initial anti-VEGF agent.</p><p><strong>Results: </strong>Of 1677 examined eyes, 1600 had ROP; 283 had A-ROP (mean BW 712 g, mean GA 24.8 weeks) and 1317 had non-A-ROP (mean BW 812 g, mean GA 25.9 weeks). Infants with A-ROP had lower mean BW and GA (p<i><</i>0.001). Across A-ROP cases, each 100 g increase in BW decreased re-injection risk by 26% (p=0.041). Compared with bevacizumab, ranibizumab was associated with a higher risk of re-injection in A-ROP eyes (risk ratio=4.82, p=0.009). ROP zone II was associated with a 2.48-fold higher risk of re-injection than zone I (p<i>=</i>0.014), which was attenuated after correction for bilaterality.</p><p><strong>Conclusions and relevance: </strong>A-ROP is associated with lower BW, lower GA at birth and more posterior ROP zone than non-A-ROP. Lower BW and initial ranibizumab treatment are related to greater risk of repeat anti-VEGF injection. There was more retreatment in zone II A-ROP eyes compared with those in zone I, which did not persist after correction for bilaterality.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849751","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":"Astigmatism trends in adults of Hong Kong from 2015 to 2024: The Hong Kong Children Eye Study.","authors":"Ka Wai Kam, Anakin Chu Kwan Lai, Arnold Shau Hei Chee, Yuzhou Zhang, Erica Shing, Mandy P H Ng, Alvin L Young, Clement C Tham, Chi Pui Pang, Li Jia Chen, Jason C Yam","doi":"10.1136/bjo-2026-329895","DOIUrl":"https://doi.org/10.1136/bjo-2026-329895","url":null,"abstract":"<p><strong>Background/aims: </strong>To investigate temporal trends in refractive and corneal astigmatism (CA) in adults and examine their association with the COVID-19 pandemic.</p><p><strong>Methods: </strong>This population-based cross-sectional study included adults (≥18 years) recruited from parents participating in the Hong Kong Children's Eye Study who underwent comprehensive ocular examinations at two academic centres (2015-2024). Refractive error of the worse eye and corresponding CA were measured using an autorefractor and optical biometry without cycloplegia. Age-standardised prevalence was calculated annually. Logistic regression assessed associations between the pandemic period and astigmatism, adjusting for age, sex, axial length and spherical equivalent.</p><p><strong>Results: </strong>A total of 29 583 adults (mean age 40.6±5.6 years; 35.3% men) were included. Age-standardised prevalence of refractive astigmatism (RA) increased from 41.7% in 2015 to 46.2% in 2024 (p=0.002) and CA from 45.0% to 52.9% (p=0.002). Compared with 2015, the adjusted odds of RA in 2024 increased by 52% (OR 1.52, 95% CI 1.30 to 1.76; p=9.34×10^-8), and CA by 47% (OR 1.47, 95% CI 1.27 to 1.71; p<i>=</i>2.38×10^-7). Mean refractive and CA increased by 0.11 D and 0.14 D, respectively. A shift towards moderate and severe astigmatism was observed. CA correlated strongly with K2 (β=0.891, p<0.001).</p><p><strong>Conclusions: </strong>The prevalence and severity of astigmatism in adults increased following the COVID-19 pandemic, independent of axial length and spherical equivalent. Findings suggest corneal changes, especially along the steep meridian, may underlie this trend and warrant further investigation into environmental and lifestyle factors.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849835","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 insights of minocycline as a neurovascular protective agent in retinitis pigmentosa.","authors":"Yuxi Chen, Yuxun Shi, Guanyu Chen, Yanyan Xie, Zhiqiang Xiao, Hao Wu, Xiaoqing Chen, Yiwen Xia, Minzhen Wang, Dan Liang, Yuan Pan","doi":"10.1136/bjo-2025-328440","DOIUrl":"https://doi.org/10.1136/bjo-2025-328440","url":null,"abstract":"<p><strong>Background/aims: </strong>Retinitis pigmentosa (RP) is characterised by progressive photoreceptor degeneration accompanied by vascular abnormalities. We have previously demonstrated that minocycline exhibits therapeutic potential in RP. This trial aimed to evaluate its neurovascular protective effects.</p><p><strong>Methods: </strong>Patients with RP were enrolled and administered 100 mg of minocycline once daily for 12 months. A total of 32 eyes from 16 participants were included. The primary outcomes were changes in retinal and choroidal vasculature, including vessel density, lacunarity, foveal avascular zone (FAZ) area, fluorescein angiography (FA) score and subfoveal choroidal thickness (SFCT). The secondary outcomes included changes in photoreceptor structure and function, including ellipsoid zone width, best-corrected visual acuity (BCVA), mean macular sensitivity, mean deviation (MD) and error score. Adverse events were recorded. Additionally, Rd1 mice were used to further investigate the vascular effects of minocycline.</p><p><strong>Results: </strong>After 12-month minocycline treatment, RP patients exhibited increased vessel density in both the retinal superficial capillary plexus (SCP) and retinal deep capillary plexus (DCP), accompanied by reduced FAZ area and decreased lacunarity in the SCP and DCP. FA score and SFCT remained stable, as did all secondary outcomes. A total of 24 adverse events were reported in 8 patients, and all resolved spontaneously without additional intervention. Additional experiments in Rd1 mice demonstrated improved retinal vascular abnormalities and preserved blood-retinal barrier integrity, accompanied by upregulated expression of tight junction proteins.</p><p><strong>Conclusions: </strong>Oral 100 mg minocycline once daily for 12 months was beneficial to protect vascular integrity and stabilise photoreceptor structure and function with good tolerability.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849850","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}