British Journal of Ophthalmology最新文献

{"title":"Lens attachment guard (LAG): a novel protection system for lenses used in ophthalmology.","authors":"Athul S Puthalath, Kannan Naresh Babu, Muthukrishnan Vallinayagam, Kim Ramasamy","doi":"10.1136/bjo-2025-327899","DOIUrl":"https://doi.org/10.1136/bjo-2025-327899","url":null,"abstract":"<p><strong>Background: </strong>To create and clinically test the Lens Attachment Guard (LAG), a 3D-printed protective attachment for the prevention of incidental falls and breakage of ophthalmic lenses employed in laser treatments like pan-retinal photocoagulation (PRP).</p><p><strong>Methods: </strong>The LAG system was designed after several cases of lens damage in a busy clinical practice. It was created with Computer-Aided Design software and produced with thermoplastic polyurethane (TPU) through 3D printing. Iterative prototyping was done to maximise fit, optical compatibility and user-friendliness. The last prototype consisted of three primary elements: a winding clip, thread lock and 3D-printed lens holder.</p><p><strong>Results: </strong>The LAG system ensured safe lens stabilisation without compromising laser delivery or visualisation. TPU had shock-absorption and was sterilisation compatible. There were no drops of lenses reported when used. Clinician input revealed enhanced procedural confidence and minimal interference with workflow. The system proved versatile for varied lens types and was readily cleaned and could be reused from case to case.</p><p><strong>Conclusion: </strong>The LAG is a user-friendly, reusable and inexpensive innovation that satisfies a previously unmet need in ophthalmic practice. Its use can have a significant impact on reducing lens damage, increasing procedural safety and increasing clinical efficiency. Multicentre validation and increased lens compatibility testing are ongoing.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839187","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":"Variation in cataract surgical outcomes by facility type: evidence from 168 population-based surveys in 61 countries.","authors":"Mattan Arazi, Drew Burd, Samuel H Henok, Elliott H Taylor, Covadonga Bascaran, Catey Bunce, John Buchan, Sailesh Kumar Mishra, Reena Yadav, Andrew Bastawrous, Shalinder Sabherwal, Stephen Gichuhi, Jacqueline Ramke, Matthew J Burton, Ian McCormick","doi":"10.1136/bjo-2026-329992","DOIUrl":"https://doi.org/10.1136/bjo-2026-329992","url":null,"abstract":"<p><strong>Background/aims: </strong>To compare visual outcomes after cataract surgery between outreach camps and fixed facilities, and among government, non-governmental organisation (NGO) and private providers within fixed facilities.</p><p><strong>Methods: </strong>Pooled cross-sectional analysis of 41 881 cataract-operated eyes from adults aged 50 years and older in 168 population-based Rapid Assessment of Avoidable Blindness surveys across 61 countries. Analyses were restricted to surgeries performed between 2000 and 2020. Multilevel logistic regression with random intercepts for country, survey, cluster and individual was used to estimate the association between surgical setting and achieving presenting visual acuity of 6/18 or better, adjusting for age at surgery, sex, year of surgery and Global Burden of Disease super-region.</p><p><strong>Results: </strong>Outreach camps accounted for 9.7% of surgeries and had a lower adjusted probability of achieving presenting visual acuity of 6/18 or better than fixed facilities (60.6% vs 66.6%; OR 0.59 (95% CI 0.50 to 0.70)). Within fixed facilities, probabilities were 64.8% in government hospitals, 66.8% in NGO hospitals and 69.5% in private hospitals. Compared with government hospitals, outcomes were similar in NGO hospitals (OR 1.21 (95% CI 0.95 to 1.53)) and better in private hospitals (OR 1.56 (95% CI 1.25 to 1.94)). Outcomes improved across all delivery models over time, but differences between settings remained unchanged.</p><p><strong>Conclusions: </strong>In settings where outreach services account for a substantial proportion of surgical volume, persistently poorer outcomes may constrain gains in effective cataract surgical coverage. These findings highlight the importance of improving the organisation and quality of outreach surgery and strengthening public cataract surgical services.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839217","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":"Efficacy and safety of ELIOS excimer laser trabeculostomy versus iStent inject as an adjunct to phacoemulsification: a retrospective comparative study.","authors":"Thomas Jacobs, Ronald M P C De Crom, Jan Van Eijgen, Vincent Walgrave, Mehmet Ikinci, Matthew Hochuen Ip, Nathan M Kerr, Neeru A Vallabh, Keith Barton, Keith R Martin, Dan Lindfield, Henny J M Beckers, Gokulan Ratnarajan, Ingeborg Stalmans","doi":"10.1136/bjo-2026-329700","DOIUrl":"https://doi.org/10.1136/bjo-2026-329700","url":null,"abstract":"<p><strong>Background/aims: </strong>Minimally invasive glaucoma surgery (MIGS) procedures are commonly combined with phacoemulsification to provide additional intraocular pressure (IOP) and/or topical medication reduction in patients with mild-to-moderate glaucoma. This study compared the 1-year efficacy and safety of excimer laser trabeculostomy (ELIOS) versus trabecular micro-bypass stenting (iStent inject and iStent inject W), both performed in combination with cataract surgery.</p><p><strong>Methods: </strong>This multicentre retrospective cohort study included patients undergoing combined phacoemulsification with either ELIOS (Phaco-ELIOS) or iStent implantation (Phaco-iStent) at three European centres between 2020 and 2025. The primary endpoint was IOP at 12 months postoperatively. Secondary endpoints included longitudinal IOP and medication use, surgical success, adverse events and the need for secondary glaucoma surgery. Longitudinal outcomes were analysed using multiple imputation.</p><p><strong>Results: </strong>A total of 343 eyes were included (164 Phaco-ELIOS and 179 Phaco-iStent), with 1-year follow-up available in 70%. Mean IOP decreased by 21.6% for Phaco-ELIOS and 20.7% for Phaco-iStent and remained stable through 12 months (p=0.74). Both procedures were associated with a similar reduction in postoperative topical glaucoma medications (0.56 vs 0.41; p=0.2). With Phaco-ELIOS, a higher proportion of eyes achieved medication reduction (46.4% vs 31.3%; p=0.02). Rates of adverse events and secondary glaucoma surgery were low and comparable in both groups.</p><p><strong>Conclusion: </strong>Phaco-ELIOS and Phaco-iStent provided comparable 1-year IOP reduction and overall safety. Phaco-ELIOS showed a greater number of patients with topical medication reduction, supporting its role as an effective combined MIGS option in patients undergoing cataract surgery.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839175","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":"Automated AI quantification of retinal parameters associated with axial length progression in children: a cohort study.","authors":"Zixun Wang, Xiaoling Zhang, Jingtao Yu, Daqian Lu, Zhiqing Li, Xueshuo Xie, Shujun Zhang, Jie Wang, Bei Du, Ruihua Wei","doi":"10.1136/bjo-2026-329518","DOIUrl":"https://doi.org/10.1136/bjo-2026-329518","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated whether quantitative retinal parameters derived from colour fundus photography are associated with axial length (AL) progression in school-age children.</p><p><strong>Methods: </strong>In this prospective cohort, 556 school-age children underwent comprehensive baseline evaluations, including cycloplegic refraction, AL measurement and colour fundus photography (CFP) at baseline and follow-up. Quantitative retinal features were automatically extracted from fundus images using an artificial intelligence (AI)-assisted platform. Children were classified into Group 0 and Group 1 according to an annual AL progression of 0.2 mm. Univariable screening was followed by multivariable logistic regression adjusted for sex and baseline AL. Sensitivity analyses were adjusted for baseline SE or simultaneously for baseline AL and SE and included standardised effect estimates and Firth bias-reduced logistic regression.</p><p><strong>Results: </strong>Among 556 children, 276 were classified as Group 0 and 280 as Group 1. After adjustment for sex and baseline AL, greater average venous curvature between 0.5 and 1.0 PD remained associated with lower odds of AL progression (OR per SD increase=0.79, 95% CI 0.66 to 0.95, p=0.012), whereas the association with the macula-optic disc angle was attenuated (OR per SD increase=0.85, 95% CI 0.71 to 1.01, p=0.068). Venous curvature remained significant in sensitivity analyses adjusting for baseline SE or both baseline AL and SE.</p><p><strong>Conclusion: </strong>Selected quantitative fundus features, particularly peripapillary venous curvature, were associated with 1 year AL progression in school-age children. These findings suggest that CFP-derived parameters may have potential value as indicators of AL progression, although further validation in independent cohorts is needed.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825167","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":"Interaction of genetic susceptibility and sunlight exposure on primary open-angle glaucoma risk and progression.","authors":"Yun Hsia, I-Chieh Chen, Hui-Wen Yang, Wei-Wei Liu, De-Xian Li, Chien-Yun Tsai, Jun-Peng Chen, Yi-Ming Chen, I-Jong Wang, Mi-Hyun Nam, Chien-Chih Chou","doi":"10.1136/bjo-2026-330421","DOIUrl":"https://doi.org/10.1136/bjo-2026-330421","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the role of sunlight exposure and its interaction with genetic susceptibility in primary open-angle glaucoma (POAG).</p><p><strong>Methods: </strong>Among 63 343 participants in the Taiwan Precision Medicine Initiative project who visited Taichung Veterans General Hospital, patients with POAG were identified and controls were matched 1:4 by sex, age and index year. Solar insolation at 6 months before glaucoma diagnosis was estimated from residential data using Quantum Geographic Information System. Genotyping was performed and polygenic risk scores (PRS; PGS004766) were calculated. Optical coherence tomography and standard automated perimetry were performed; retinal nerve fibre layer (RNFL) and mean deviation slopes were estimated. Logistic regression and linear mixed models assessed the effects of sunlight exposure and genetic susceptibility on the risk and progression rate of POAG. Mediation analysis assessed whether intraocular pressure (IOP) mediated the effect of sunlight exposure on POAG.</p><p><strong>Results: </strong>We included 745 participants (mean age 52.0 ±14.2 years; 49% male). After adjusting for age, sex, IOP, comorbidities, urbanisation level and PRS, sunlight exposure significantly associated with greater POAG risk (adjusted OR: 1.20; 95% CI 1.05 to 1.38, p=0.009). Among high-sunlight exposure individuals, POAG proportion increased from 17% to 36% across PRS quartiles (p<0.001); in contrast, no trend was seen in the low-sunlight exposure group. Greater sunlight exposure correlated with faster RNFL thinning (β=-0.09, 95% CI -0.17 to -0.01; p=0.026). Mediation analysis showed that the association between sunlight exposure and POAG was not mediated by IOP (p=0.728).</p><p><strong>Conclusion: </strong>Greater sunlight exposure was modestly associated with higher POAG risk and faster progression independent of IOP, particularly among genetically susceptible individuals.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825218","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 retinal/choroidal vascularity and macular sensitivity in myopic macular degeneration: Aier-SERI high myopia adult cohort study.","authors":"Yanfeng Jiang, Kai Xiong Cheong, Ziqi Hu, Li-Lian Foo, Yongli Zhou, Xiangzhong Tang, Wei Pan, Zhongping Chen, Seang-Mei Saw, Quan V Hoang, Zhikuan Yang, Weizhong Lan","doi":"10.1136/bjo-2025-328323","DOIUrl":"https://doi.org/10.1136/bjo-2025-328323","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the associations between retinal/choroidal vascular parameters and macular sensitivity (MS) in adults with myopic macular degeneration (MMD).</p><p><strong>Methods: </strong>This cross-sectional study included a total of 439 eyes from 253 participants of the Aier-SERI high myopia cohort in Changsha, central China. MS was evaluated using the microperimetry (MP-3). Retinal and choroidal vascular parameters, including superficial vascular density (SVD), deep vascular density (DVD), choriocapillaris perfusion area (CCPA) and choroidal vascularity index (CVI), were quantified using swept-source optical coherence tomography angiography (SS-OCTA). Differences in MS across MMD severity categories were analysed via one-way analysis of variance, and relationships between retinal/choroidal vascular parameters and MS were evaluated using multivariable linear regression models with generalised estimating equations to account for inter-eye correlations.</p><p><strong>Results: </strong>Participants had an average age of 44.6±6.6 years with a mean spherical equivalent (SE) of -9.1±4.1 D and axial length (AL) of 27.2±1.8 mm. MS, SVD, DVD and CVI in different regions decreased with increasing severity of MMD (all <i>P</i> values <0.05), but CCPA not (p>0.05). In multivariate models, factors related to reduced MS included older age (β=-0.074, p=0.007), longer AL (β=-0.388, p<0.001), increasing severity of MMD (β≤-0.677, all p<0.05), lower SVD (β=0.077, p=0.022), lower DVD (β=0.069, p=0.019) and lower CVI (β=3.083, p=0.015). CVI demonstrated significantly greater discriminatory power for MS impairment compared with SVD and DVD in different regions (all P values <0.05).</p><p><strong>Conclusion: </strong>Reduced MS is associated with more severe MMD, older age, longer AL, lower SVD, lower DVD and lower CVI. Among retinal/choroidal vascular biomarkers, CVI exhibits superior diagnostic utility for identifying MS impairment in MMD, highlighting the choroid's potential role as a sensitive indicator of visual function.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817592","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":"Posterior capsular rupture and phacoemulsification device.","authors":"Mahmoud Ahmed, Maria Laura Passaro, Stephen B Kaye","doi":"10.1136/bjo-2026-330295","DOIUrl":"https://doi.org/10.1136/bjo-2026-330295","url":null,"abstract":"<p><strong>Background: </strong>To investigate whether phacoemulsification platform type and phaco tip design are associated with differences in unadjusted posterior capsular rupture (PCR) rates in cataract surgery.</p><p><strong>Methods: </strong>This retrospective observational study used centre-level data from UK National Health Service (NHS) cataract surgery centres included in the 2024 National Ophthalmology Database Cataract Audit, with a complementary analysis from two tertiary NHS centres. Phacoemulsification platform and principal tip design were identified by contacting each centre. Unadjusted PCR rates were compared using χ² tests with ORs and 95% CIs. A separate eye-level analysis assessed the association between tip design and PCR after adjusting for surgeon experience.</p><p><strong>Results: </strong>Twenty-four NHS centres contributed 166 213 cataract operations, with a mean unadjusted PCR rate of 1.48% (SD 0.61%). Among 44 202 procedures, Alcon systems accounted for 25 921 cases with 462 PCRs (1.78%), while Bausch & Lomb systems accounted for 18 281 cases with 202 PCRs (1.10%) (OR 1.62, 95% CI 1.38 to 1.92; p<0.0001). Flared tips were associated with higher unadjusted PCR rates than straight tips (2.12% vs 1.30%; OR 1.64, 95% CI 1.40 to 1.93; p<0.0001). In the local eye-level cohort, flared tips remained associated with higher odds of PCR after adjustment for surgeon experience (OR 2.33, 95% CI 1.18 to 5.13).</p><p><strong>Conclusions: </strong>In this national audit sample, phacoemulsification platform and tip architecture were associated with differences in unadjusted PCR rates. Similar associations were observed in a complementary eye-level analysis adjusting for surgeon experience. Given the unadjusted nature of the data and the lack of adjustment for case complexity, surgical technique, training and fluidics configuration, these findings should be interpreted with caution, and further prospective risk-adjusted studies are needed.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817597","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":"<i>Pythium</i> keratitis: experience from Thailand.","authors":"Vilavun Puangsricharern, Thanachaporn Kittipibul, Wasee Tulvatana","doi":"10.1136/bjo-2026-329435","DOIUrl":"https://doi.org/10.1136/bjo-2026-329435","url":null,"abstract":"<p><p><i>Pythium insidiosum</i> keratitis is a rare but highly aggressive corneal infection that closely mimics fungal keratitis yet responds poorly to conventional antifungal therapy. Although previously under-recognised, it is increasingly reported in tropical and subtropical regions, particularly Southeast Asia, and is associated with high rates of therapeutic keratoplasty and globe loss. This review summarises current evidence on the epidemiology, risk factors, pathogenesis, clinical presentation, diagnostic strategies and management of <i>Pythium</i> keratitis, with particular emphasis on data from endemic regions. The disease typically affects otherwise healthy individuals with antecedent ocular trauma, agricultural exposure or contact with contaminated water. Clinically, it is characterised by rapid progression, tentacular or reticular stromal infiltrates, early deep stromal involvement, and frequent limbal extension, often mimicking filamentous fungal keratitis. Definitive diagnosis requires a combination of direct microscopy with specialised staining, culture with zoospore induction, histopathology and molecular techniques, particularly PCR assays targeting the internal transcribed spacer region. The absence of ergosterol in the organism's cell membrane renders antifungal agents largely ineffective. Emerging evidence supports targeted antibacterial therapy, especially linezolid- and azithromycin-based regimens, which have been associated with improved outcomes and reduced need for surgical intervention. Early recognition, organism-specific diagnosis and prompt initiation of appropriate therapy are essential to improve visual and anatomical outcomes in affected patients.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812032","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 fenofibrate use with progression of ocular disease in individuals with diabetes.","authors":"Courtney Oliver, Meghan K Berkenstock, Mira M Sachdeva","doi":"10.1136/bjo-2026-329642","DOIUrl":"https://doi.org/10.1136/bjo-2026-329642","url":null,"abstract":"<p><strong>Background/aims: </strong>Fenofibrates may slow progression of diabetic retinopathy (DR). This study used the large international TriNetX database to evaluate progression of retinopathy and development of cataracts, primary open angle glaucoma (POAG) and diabetic macular oedema (DME) in patients with diabetes with and without fenofibrate use.</p><p><strong>Methods: </strong>In this retrospective cohort study, ICD10 codes and RxNorm were used to identify patients in the TriNetX database aged ≥18 years with a diagnosis of diabetes mellitus (DM), with mild or moderate non-proliferative diabetic retinopathy (NPDR) and with and without fenofibrate use from December 2014 through December 2024. ORs were calculated to analyse the proportion of individuals with mild or moderate NPDR using fenofibrate who developed vision-threatening DR (VTDR, defined as severe NPDR or proliferative DR), cataracts, POAG or DME compared with those not taking fenofibrate. Those with cataracts, POAG or DME at baseline were excluded from their respective outcomes analyses.</p><p><strong>Results: </strong>After propensity score matching, 4316, 4200, 4073 and 4571 individuals prescribed fenofibrate were compared with the same number who were not prescribed fenofibrate for progression to VTDR, cataract, POAG or DME, respectively. The ORs for DR progression (OR 0.528, 95% CI 0.333 to 0.838; p=0.0059), cataract (OR 0.585, 95% CI 0.441 to 0.774; p=0.0002) and DME (OR 0.316, 95% CI 0.243 to 0.411; p<0.0001) development were lower for individuals taking fenofibrate compared with those not taking fenofibrate.</p><p><strong>Conclusion: </strong>Fenofibrate use is associated with significantly lower risk of developing VTDR, cataracts and DME in patients with mild or moderate NPDR.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788584","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":"Aflibercept 8 mg versus faricimab for macular oedema due to retinal vein occlusion: a systematic review and network meta-analysis.","authors":"Zhengyang Liu, Sujan A Surendran, Elaine W Chong","doi":"10.1136/bjo-2026-330185","DOIUrl":"https://doi.org/10.1136/bjo-2026-330185","url":null,"abstract":"<p><strong>Aim: </strong>To indirectly evaluate the comparative efficacy and safety of aflibercept 8 mg and faricimab in treating retinal vein occlusion (RVO)-associated macular oedema.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase and Cochrane CENTRAL from inception to 11 December 2025. We performed frequentist network meta-analysis on efficacy and safety outcomes at loading phase completion (24-40 weeks), with 4 weekly aflibercept 2 mg as the common comparator.</p><p><strong>Results: </strong>Three trials with 2174 adults were included. 8 weekly aflibercept 8 mg with five 4 weekly loading doses was more likely to achieve a best corrected visual acuity (BCVA) of ≥69 letters (Snellen 20/40, unconditional driving threshold) compared with 4 weekly faricimab (risk ratio (RR) 1.18, 95% CI 1.03 to 1.35). 4 weekly faricimab demonstrated greater rates of complete resolution of intraretinal and subretinal fluid against 8 weekly aflibercept 8 mg with both five and three 4 weekly loading doses (both RR 1.12, 95% CI 1.01 to 1.25). There was no evidence of a difference in mean BCVA improvement between agents. Both aflibercept 8 mg and 2 mg regimens were associated with a greater risk of clinically significant intraocular pressure (IOP) rise of 30-60 min post-injection compared with 4 weekly faricimab (8 weekly aflibercept 8 mg with five 4 weekly loading doses, RR 6.42, 95% CI 1.85 to 22.34; 8 weekly aflibercept 8 mg with three 4 weekly loading doses, RR 6.97, 95% CI 2.02 to 24.08; 4 weekly aflibercept 2 mg, RR 2.12, 95% CI 1.01 to 4.47).</p><p><strong>Conclusion: </strong>Aflibercept 8 mg and faricimab show comparable overall visual efficacy for RVO-associated macular oedema. Indirect comparisons suggest aflibercept 8 mg may increase the probability of achieving driving vision, while faricimab may offer greater anatomical drying and a lower risk of acute IOP elevation.</p><p><strong>Prospero registration number: </strong>CRD420251249785.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788586","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}