British Journal of Ophthalmology最新文献

{"title":"Long-term visual outcomes and side effects of ruthenium plaque brachytherapy in 310 eyes with small choroidal melanoma.","authors":"Beatrice Gallo, Rohan Hussain, Ranaa Al-Jamal, Hagar Khalid, Ian Stoker, Gordon Hay, Amit K Arora, Mandeep S Sagoo","doi":"10.1136/bjo-2023-324686","DOIUrl":"https://doi.org/10.1136/bjo-2023-324686","url":null,"abstract":"<p><strong>Background/aims: </strong>To report the long-term visual outcomes and side effects in patients with small choroidal melanoma (CM) undergoing ruthenium-106 (Ru-106) plaque brachytherapy.</p><p><strong>Methods: </strong>Retrospective, interventional, consecutive series of small CM ≤2.5 mm in height and ≤16 mm in largest basal diameter treated with Ru-106 plaque with a median radiation dose of 100 Gy prescribed to tumour apical height.</p><p><strong>Results: </strong>310 patients (160 men) with a mean (SD) age of 58.4±14.1 years met the study inclusion criteria. The median follow-up was 57.5 (range 3.4-170.5) months. The mean tumour baseline thickness was 1.9±0.4 (range 0.4-2.5) mm. The mean baseline logarithm of the minimum angle of resolution (logMAR) of best corrected visual acuity (BCVA) was 0.21±0.4 (Snellen equivalent 6/9; range -0.1 to 1.5). Mean final BCVA was ≤0.3 logMAR (Snellen equivalent 6/12) in 161 patients (54.2%), better than 1.0 logMAR (Snellen equivalent 6/60) and <0.3 logMAR in 59 patients (19.9%), and ≥1.0 logMAR in 77 patients (25.9%). Kaplan-Meier estimates of poor final VA (≥1.0 logMAR) were 13.2% at 5 years and 54.5% at 10 years. Early and late complications developed in 20.6% and 42.6% of cases, respectively. Radiation maculopathy was the most frequent late side effect (29% of patients) with Kaplan-Meier rates of 18.2%, 31.7% and 42.1% at 3, 5 and 10 years, respectively. Older age, lipofuscin, proximity to fovea, final tumour elevation and radiation maculopathy predicted visual loss ≥5 Snellen lines.</p><p><strong>Conclusion: </strong>Despite early and late complications in 20.6% and 42.6% of cases, Ru-106 brachytherapy for small CM allows retention of BCVA ≤0.3 logMAR in half of the eyes.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights from 1096 clinical cases: pioneering a universal grading system for vernal keratoconjunctivitis management.","authors":"Ambika Chandrasekar,Shweta Agarwal,Gaurav Chauhan,Bhaskar Srinivasan,Varsha Bhambani Chavda,Geetha Iyer","doi":"10.1136/bjo-2024-325762","DOIUrl":"https://doi.org/10.1136/bjo-2024-325762","url":null,"abstract":"AIMTo analyse the clinical and demographic profiles of patients with vernal keratoconjunctivitis (VKC) and propose a grading for VKC based on corneal status and symptom periodicity rather than disease activity.METHODSRetrospective observational study from January 2015 to January 2020 in India. VKC grading was based on past/present clinical signs and frequency of symptoms rather than disease activity. The electronic medical records were screened and details of VKC patients diagnosed by cornea specialists were recorded and analysed.RESULTS1096 VKC patients with a mean age of onset of 7.05±5.3 with 8.39% having adult onset were analysed. Symptoms included; itching (50.55%) and decreased vision (15.44%). Mixed VKC (52.04%) was the most common presentation with 49.1% having active disease. Complications included; keratoconus (18.43%), steroid-induced cataract (11.41%), glaucoma (10.95%) and limbal stem cell deficiency (5.29%). Dual-acting antiallergics (69.39%) were most commonly used, followed by topical immunomodulators.The patients were graded as, grade I: mild-presence of mild and seasonal symptoms and/or signs. Grade II: moderate-presence of persistent symptoms/and/or signs without corneal involvement. Grade III: severe-chronic persistent symptoms/and/or intermittent signs with corneal involvement or asymptomatic to mild symptoms with corneal pathognomonic signs. Grade IV: very severe-chronic persistent symptoms and/or corneal pathognomonic signs or active involvement/complication or asymptomatic with complications.CONCLUSIONVKC is a chronic disease that often causes visual complications. The new grading system based on the cornea status and symptom periodicity rather than disease activity might help plan the management better.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"53 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062037","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":"Characterisation of delayed severity flares in patients with HLA-B27-associated anterior uveitis.","authors":"Andrew M Philip, Fatima Babiker, Carla C Fernandez-Santos, Max N Chikovsky, Andrew H Dolinko, Koosha Ramezani, Sydney Look-Why, Ambika Manhapra, Maria L Ruggeri, Peter Y Chang, Stephen Foster, Stephen D Anesi","doi":"10.1136/bjo-2024-325364","DOIUrl":"10.1136/bjo-2024-325364","url":null,"abstract":"<p><strong>Background/aims: </strong>To explore and characterise the clinical phenotype of acute anterior uveitis flares with delayed severity in patients with human leucocyte antigen B27 (HLA-B27)-associated anterior uveitis.</p><p><strong>Methods: </strong>Retrospective chart review of patients with HLA-B27-associated anterior uveitis. Demographic and clinical data were recorded, as well as the clinical characteristics of acute anterior uveitis flares. A flare was considered to have delayed severity if any of the following criteria were met within 3-21 days of symptomatic onset: a two-step increase in anterior chamber inflammation on consecutive exams; a new development of hypopyon or fibrinoid aqueous reaction on consecutive examinations or a significant worsening of symptoms.</p><p><strong>Results: </strong>A total of 371 patient charts were identified, of which 137 were included. 321 acute anterior uveitis flares were documented, with 36 (11.2%) meeting the criteria for a delayed severity flare. The average time from symptomatic onset was 10.2 days, and patients presented with an average anterior chamber cell grade of 3.5 in delayed severity flares compared with 1.6 in non-delayed severity flares. No significant difference in frequency of delayed severity presentation was noted based on the presence or absence of systemically associated rheumatological disease, papillitis on initial presentation and retinal vasculitis on initial presentation. The frequency of topical steroid therapy after symptomatic onset was not significantly different between the two flare phenotypes.</p><p><strong>Conclusions: </strong>Our study presents the novel characterisation of a delayed severity phenotype of HLA-B27-associated acute anterior uveitis flares.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"199-202"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874214","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":"Expert CONsensus on Visual Evaluation in Retinal disease manaGEment: the CONVERGE study.","authors":"Roger S Anderson, Mark Roark, Rose Gilbert, Dayyanah Sumodhee","doi":"10.1136/bjo-2024-325310","DOIUrl":"10.1136/bjo-2024-325310","url":null,"abstract":"<p><strong>Background/aims: </strong>Recent decades have seen significant advances in both structural and functional testing of retinal disease. However, the current clinical value of specific testing modalities, as well as future trends, need to be clearly identified in order to highlight areas for further development in routine care and clinical trials.</p><p><strong>Methods: </strong>We designed a modified two-round Delphi study to obtain the opinion of a multidisciplinary group of 33 international experts involved in the field of retinal disease management/research to determine the level of agreement and consensus regarding the value and performance of specific structural and functional testing methods for retinal disease. On a Likert scale, a median of 1-2 indicated disagreement with the statement, and 5-6 indicated agreement with the statement. An IQR of ≤2 indicated consensus in the responses. Several questions also allowed comments on responses.</p><p><strong>Results: </strong>There was overall agreement that structural testing currently predominates for detection and monitoring. There was moderate agreement that functional testing remains important and will continue to do so in the future because it provides complementary information. Certain respondents considered that properly designed and applied psychophysical tests are as reliable and repeatable as structural observations and that functional changes are the most important in the long run. Respondents considered future care and research to require a combination of structural and functional testing with strong consensus that the relative importance will depend on disease type and stage.</p><p><strong>Conclusion: </strong>The study obtained important insights from a group of international experts regarding current and future needs in the management of retinal disease using a mix of quantitative and qualitative approaches. Responses provide a rich range of opinions that will be of interest to researchers seeking to design tests for future patient care and clinical trials.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"228-236"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859073","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":"Sympathetic ophthalmia: epidemiology and cohort-based assessment of clinical outcomes.","authors":"Tim J Patterson, Weidong Gu, David Eliason, William Rojas-Carabali, Bernett Lee, Padmamalini Mahendradas, Jyotrimay Biswas, Parthopratim Dutta Majumder, Manisha Agarwal, Carlos Pavesio, Vishali Gupta, Rupesh Agrawal, Richard James Blanch","doi":"10.1136/bjo-2024-325267","DOIUrl":"10.1136/bjo-2024-325267","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to report the incidence, time after inciting event, aetiology and risk after specific intraocular procedures and the visual outcomes associated with sympathetic ophthalmia (SO) occurrence.</p><p><strong>Methods: </strong>This study reports data from multiple retrospective cohorts: retrospective population-based data were extracted from the TRICARE service network (between 2017 and 2021) and retrospective case-based data from the Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) database (cohorts from the UK, South India and North India).</p><p><strong>Results: </strong>There were 159 patients with SO identified. The length of time from sensitising event to SO occurrence was a median of 151 days (range: 6-9100 days).In the TRICARE database, 2 patients developed SO after open globe trauma and primary repair (of 615 eyes, rate 0.33%; 95% CI 1.26% to 1.30%). None developed SO after vitrectomy (total of 23 903 events; 95% CI 0% to 0.012%). The combined North Indian and UK cohorts reported 78.6% (81 patients) after trauma, 18.45% (19 patients) after elective surgery.Visual outcomes were reported in the OASIS database for 98.01% of patients (155 of 157 patients). The median presenting and final best corrected visual acuity (BCVA) for the inciting eye were no perception of light, the median presenting and final BCVA for the sympathising eye were 0.65 and 0.3 logMAR, respectively.</p><p><strong>Conclusion: </strong>This study identified 159 cases of SO. With poor visual outcomes in the inciting eye, early diagnosis and management are crucial for optimising visual outcomes in the sympathising eye.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"223-227"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364494","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 long-term statin use and cataract surgery: a nationwide study on 505 105 cataract surgery patients.","authors":"Andrim Halili, Saranda Haxha, Bochra Zareini, Casper Lund-Andersen, Kathrine Kold Sørensen, Christian Torp-Pedersen, Talip E Eroglu, Casper Niels Bang","doi":"10.1136/bjo-2022-322409","DOIUrl":"10.1136/bjo-2022-322409","url":null,"abstract":"<p><strong>Aims: </strong>To assess the association between statin use and cataract surgery according to different statin treatment durations in patients with different cardiovascular risk profiles.</p><p><strong>Methods and results: </strong>We performed a nested case-control study using Danish registries, covering the period from 1 January 1996 to 31 December 2020. We defined cases as surgically treated cataract patients, matched in a 1:1 ratio by sex and age with controls not undergoing cataract surgery. The exposure of interest was statin use in different durations (1, 5 and 10 years) compared with never use of statins. Conditional logistic regression provided adjusted HRs and corresponding 95% CIs in subgroups defined by established atherosclerotic cardiovascular disease, diabetes, hypertension and individuals without these comorbidities. We identified 505 150 cataract surgery cases and found no increased HR of cataract surgery with statin treatment at any duration in any of the subgroups with established atherosclerotic cardiovascular disease, diabetes or hypertension.</p><p><strong>Conclusion: </strong>Our findings do not support a possible association between long-term statin use and cataract in patients with established atherosclerotic cardiovascular disease, diabetes or hypertension. Although we found an association between statin use and cataract in individuals without these comorbidities, increasing durations of statin use did not yield higher cataract surgery rates.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"192-198"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757236","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":"Choroidal involvement in acute retinal necrosis: case series and review of the literature.","authors":"Anamika Patel, Avinash Pathengay, Carlos Pavesio, Ilaria Testi","doi":"10.1136/bjo-2024-325724","DOIUrl":"10.1136/bjo-2024-325724","url":null,"abstract":"<p><strong>Purpose: </strong>To show the role of multimodal imaging in identifying choroidal involvement in acute retinal necrosis (ARN).</p><p><strong>Methods: </strong>Retrospective case series of ARN patients. Clinical data, including medical history, clinical features and multimodal imaging findings, were collected.</p><p><strong>Results: </strong>Three patients were included. Imaging modalities, such as indocyanine green angiography and optical coherence tomography, were critical in showing choroidal involvement in ARN.</p><p><strong>Conclusion: </strong>Choroidal involvement may occur in ARN along with the well-known retinal features.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"203-208"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854895","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":"Predicting visual outcomes in keratoprosthesis surgery with critical flicker fusion frequency, B-scan, visual electrophysiology and endoscopy.","authors":"Guangcan Xu, Haolan Qi, Qianwei He, Mingxiong Chen, Junxia Fu, Qun Wang, Biyue Chen, Qing Hua Yang, Yifei Huang, Shihui Wei, Liqiang Wang","doi":"10.1136/bjo-2024-325719","DOIUrl":"10.1136/bjo-2024-325719","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the predictive power of the critical flicker fusion frequency (CFF) test for visual outcomes in keratoprosthesis (KPro) candidates, comparing its accuracy with B-scan ultrasound, flash visual evoked potentials (fVEP) and endoscopy.</p><p><strong>Methods: </strong>The study included 42 patients (42 eyes) scheduled for KPro surgery with a median follow-up period of 6 months. The receiver operating characteristic curve identified the cut-off threshold for CFF in the model development study (17 eyes). All patients in the comparison study (25 eyes) underwent preoperative assessments including trichromatic CFF (red, green and yellow), B-scan ultrasound, fVEP and perioperative endoscopy. Results were classified as either favourable or unfavourable predictors of visual outcomes based on predefined criteria. Sensitivity and specificity of each assessment were calculated based on postoperative best-corrected visual acuity (BCVA)≥20/200. The Bland-Altman test assessed the consistency between CFF-predicted BCVA and actual BCVA.</p><p><strong>Results: </strong>Among the trichromatic CFF tests, the yellow-CFF (yCFF) exhibited the highest area under the curve value of 0.97 and a cut-off threshold at 10 Hz for predicting postoperative BCVA≥20/200 (p<0.05). yCFF achieved 90% sensitivity and 80% specificity in predicting satisfactory postoperative outcomes. Endoscopy had 80% sensitivity and 80% specificity, B-scan showed 70% sensitivity and 60% specificity, and fVEP had 75% sensitivity and 40% specificity. yCFF showed a mean bias of 0.091 logarithm of the minimum angle of resolution (logMAR) in postoperative prediction.</p><p><strong>Conclusions: </strong>The CFF test provides robust visual function evaluation in KPro candidates. It demonstrates superior predictive accuracy for visual prognosis compared with routine ophthalmologic examinations, such as B-scan ultrasonography, fVEP and endoscopy.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"177-184"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995394","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":"Characterising the refractive error in paediatric patients with congenital stationary night blindness: a multicentre study.","authors":"Austin D Igelman, Elizabeth White, Alaa Tayyib, Lesley Everett, Ajoy Vincent, Elise Heon, Christina Zeitz, Michel Michaelides, Omar A Mahroo, Mohamed Katta, Andrew Webster, Markus Preising, Birgit Lorenz, Samer Khateb, Eyal Banin, Dror Sharon, Shahar Luski, Filip Van Den Broeck, Bart Peter Leroy, Elfride De Baere, Sophie Walraedt, Katarina Stingl, Laura Kuehlewein, Susanne Kohl, Milda Reith, Anne Fulton, Aparna Raghuram, Isabelle Meunier, Hélène Dollfus, Tomas S Aleman, Emma C Bedoukian, Erin C O'Neil, Emily Krauss, Andrea Vincent, Charlotte Jordan, Alessandro Iannaccone, Parveen Sen, Srilekha Sundaramurthy, Soumittra Nagasamy, Irina Balikova, Ingele Casteels, Shyamanga Borooah, Shaden Yassin, Aaron Nagiel, Hillary Schwartz, Xavier Zanlonghi, Irene Gottlob, Rebecca J McLean, Francis L Munier, Andrew Stephenson, Robert Sisk, Robert Koenekoop, Lorri B Wilson, Douglas Fredrick, Dongseok Choi, Paul Yang, Mark Edward Pennesi","doi":"10.1136/bjo-2023-323747","DOIUrl":"10.1136/bjo-2023-323747","url":null,"abstract":"<p><strong>Background/aaims: </strong>Congenital stationary night blindness (CSNB) is an inherited retinal disease that is often associated with high myopia and can be caused by pathological variants in multiple genes, most commonly <i>CACNA1F</i>, <i>NYX</i> and <i>TRPM1</i>. High myopia is associated with retinal degeneration and increased risk for retinal detachment. Slowing the progression of myopia in patients with CSNB would likely be beneficial in reducing risk, but before interventions can be considered, it is important to understand the natural history of myopic progression.</p><p><strong>Methods: </strong>This multicentre, retrospective study explored CSNB caused by variants in <i>CACNA1F</i>, <i>NYX</i> or <i>TRPM1</i> in patients who had at least 6 measurements of their spherical equivalent of refraction (SER) before the age of 18. A mixed-effect model was used to predict progression of SER overtime and differences between genotypes were evaluated.</p><p><strong>Results: </strong>78 individuals were included in this study. All genotypes showed a significant myopic predicted SER at birth (-3.076D, -5.511D and -5.386D) for <i>CACNA1F</i>, <i>NYX</i> and <i>TRPM1</i> respectively. Additionally, significant progression of myopia per year (-0.254D, -0.257D and -0.326D) was observed for all three genotypes <i>CACNA1F</i>, <i>NYX</i> and <i>TRPM1</i>, respectively.</p><p><strong>Conclusions: </strong>Patients with CSNB tend to be myopic from an early age and progress to become more myopic with age. Patients may benefit from long-term myopia slowing treatment in the future and further studies are indicated. Additionally, CSNB should be considered in the differential diagnosis for early-onset myopia.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"286-292"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854894","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":"Advances in myopia control strategies for children.","authors":"Xiu Juan Zhang, Ebenezer Zaabaar, Amanda Nicole French, Fang Yao Tang, Ka Wai Kam, Clement C Tham, Li Jia Chen, Chi Pui Pang, Jason C Yam","doi":"10.1136/bjo-2023-323887","DOIUrl":"10.1136/bjo-2023-323887","url":null,"abstract":"<p><p>Myopia has long been a global threat to public health. Timely interventions are likely to reduce the risk of vision-threatening complications. There are both established and rapidly evolving therapeutic approaches to slow myopia progression and/or delay its onset. The effective methods for slowing myopia progression include atropine eye-drops, defocus incorporated multiple segments (DIMS) spectacle lenses, spectacle lenses with highly aspherical lenslets target (HALT), diffusion optics technology (DOT) spectacle lenses, red light therapy (RLT), multifocal soft contact lenses and orthokeratology. Among these, 0.05% atropine, HALT lenses, RLT and +3.00 peripheral addition soft contact lenses yield over 60% reduction in myopia progression, whereas DIMS, DOT and MiSight contact lenses demonstrate at least 50% myopia control efficacy. 0.05% atropine demonstrates a more optimal balance of efficacy and safety than 0.01%. The efficacy of 0.01% atropine has not been consistent and requires further validation across diverse ethnicities. Combining atropine 0.01% with orthokeratology or DIMS spectacles yields better outcomes than using these interventions as monotherapies. Increased outdoor time is an effective public health strategy for myopia prevention while recent studies suggest that 0.05% low-concentration atropine and RLT therapy have promising potential as clinical myopia prevention interventions for high-risk groups. Myopia control spectacle lenses, being the least invasive, are safe for long-term use. However, when considering other approaches, it is essential to ensure proper instruction and regular follow-ups to maintain safety and monitor any potential complications. Ultimately, significant advances have been made in myopia control strategies, many of which have shown meaningful clinical outcomes. However, regular use and adequate safety monitoring over extended durations are imperative to foster confidence that can only come from extensive clinical experience.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"165-176"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080713","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}