British Journal of Ophthalmology最新文献

{"title":"Earliest location of glaucomatous retinal nerve fibre layer damage is determined by intact baseline RNFL thickness profile.","authors":"Eun Jung Lee, Do Young Park, Jong Chul Han, Changwon Kee","doi":"10.1136/bjo-2024-325630","DOIUrl":"10.1136/bjo-2024-325630","url":null,"abstract":"<p><strong>Background/aims: </strong>To identify whether an intact retinal nerve fibre layer (RNFL) thickness profile could determine the location of the earliest RNFL defect in glaucoma.</p><p><strong>Methods: </strong>Retrospective longitudinal cohort study of patients with initial unilateral glaucoma who eventually developed new glaucoma in the fellow eye. Guided progression analysis (GPA) of serial optical coherence tomography (OCT) examinations was used to identify the angular locations of the earliest RNFL defect, peak and temporal edge of the baseline RNFL profile and major vessels based on the peripapillary OCT scan circle.</p><p><strong>Results: </strong>We identified 112 new RNFL defects in 109 fellow eyes of 109 consecutive patients. The locations of new defects were superotemporal (22 eyes), inferotemporal (87 eyes) and papillomacular bundle (3 eyes), respectively. Overall, the midpoint location of the earliest RNFL defect strongly coincided with the RNFL peak (p<0.001). Specifically, the location was mildly (4.3±12.0°) temporal to, rather than at the peak thickness, particularly in eyes with a focal thinning pattern of arcuate bundles (7.8±10.8°). The close topographical relationship was consistent regardless of the interindividual variability in the RNFL profile and vessels, as well as hemispheric locations, and after adjusting for potential factors including age, refractive error, baseline intraocular pressure, tilt ratio, tilt axis and glaucoma diagnosis.</p><p><strong>Conclusion: </strong>The location of the earliest RNFL defect in glaucoma showed a close relationship with the intact RNFL profile within the same eye, regardless of variations in RNFL, hemispheric location and vessel distribution. In addition, the earliest defect was located mildly temporal to, rather than at, the peak RNFL thickness. The baseline RNFL profile may have a significant role in the regional vulnerability of glaucoma.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"572-581"},"PeriodicalIF":3.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615174","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":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary acquired melanosis with spill over periocular lentigo maligna: 19-year outcomes at a specialist eyelid and ocular oncology centre.","authors":"Mumta Kanda, Allan Zhifa Nghiem, Fariha Shafi, Shirin Hamed Azzam, Tarang Gupta, Claire Daniel","doi":"10.1136/bjo-2024-326691","DOIUrl":"10.1136/bjo-2024-326691","url":null,"abstract":"<p><strong>Background/aims: </strong>There is a paucity in the literature on the presentation, management and outcomes of cases where primary acquired melanosis (PAM) is associated with spill over/contiguous periocular lentigo maligna (LM). We describe experience of such cases at our eyelid and ocular oncology specialist centre.</p><p><strong>Methods: </strong>We conducted a retrospective consecutive case review of adult patients with PAM and periocular LM between 2005 and 2024 at Moorfields Eye Hospital in London. Demographic data, diagnosis, histology, imaging, treatment, surgical notes, outcomes and follow-up were collected from the electronic patient record.</p><p><strong>Results: </strong>Of 21 patients identified, 100% were Caucasian, 13 (62%) were women and the average age of diagnosis was 67 years. Grade of PAM atypia was mild in 5 (24%), moderate in 2 (9%) and severe in 14 (67%) patients. 16 (76%) patients developed melanoma (all types) and 12 (57%) patients developed conjunctival melanoma. Of those with PAM with severe atypia, 93% developed melanoma. The average time interval from diagnosis of PAM and LM to melanoma was 72 months. Melanoma recurrence occurred in 7 (44%) and metastases developed in 4 (25%) patients. Four patients died, including two from metastatic melanoma. Average follow-up length was 129 months.</p><p><strong>Conclusions: </strong>PAM with atypia, particularly severe atypia, when associated with spill over periocular LM, may have significant risk of progression to melanoma. Patients with PAM require careful eyelid examination to identify LM. Management requires multidisciplinary input, urgent biopsy and confocal microscopy if available, lower threshold for treatment and lifelong monitoring.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448167","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":"Effect of intra-arterial chemotherapy drug regimens on globe salvage outcomes of retinoblastoma patients.","authors":"Xiaoyu He, Minglei Han, Min Zhou, Peiwei Chai, Lei Guo, Jiayan Fan, Xuyang Wen, Xianqun Fan","doi":"10.1136/bjo-2024-326452","DOIUrl":"10.1136/bjo-2024-326452","url":null,"abstract":"<p><strong>Aims: </strong>To compare the effect of three-drug regimen (melphalan, topotecan and carboplatin) with two-drug regimen (melphalan and topotecan) on the globe salvage outcomes of retinoblastoma (Rb) with intra-arterial chemotherapy (IAC).</p><p><strong>Methods: </strong>This study included 83 patients with 87 eyes received two-drug regimen IAC, and 95 patients with 97 eyes received three-drug regimen IAC. Propensity score matching was applied, and 84 matched (42:42) patients (eyes) were analysed. All Rb patients underwent an ophthalmologic examination before IAC using a wide-angle digital fundus camera, which was repeated monthly after the globe salvage management. Progression-free ocular survival (PFOS), relapse rate and local complications were analysed per affected eye. Analysis of overall survival (OS) and systemic complications was based on Rb individuals.</p><p><strong>Results: </strong>Eyes treated with three-drug regimen IAC presented with higher overall PFOS than those treated with two-drug regimen IAC (p=0.026). Stratified analysis showed PFOS rate in three-drug group was higher than two-drug group among group D eyes (88.5% vs 60.6%, p=0.009). Consistently, among group E eyes, three-drug group correlated with a better PFOS, compared with two-drug group (42.9% vs 23.5%, p=0.002). There did not present with significant differences in OS (p=0.853), relapse rate (p=0.291), incidence of moderate-severe myelosuppression (grade 3-4, p=0.564) or ophthalmic artery obstruction (p=0.998) between these two groups.</p><p><strong>Conclusions: </strong>Three-drug regimen was a superior IAC management compared with two-drug regiment, with improved progression-free ocular outcome for eyes of advanced retinoblastomas.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424554","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":"Incidence, sociodemographic and presenting clinical features of childhood non-infectious uveitis: findings from the UK national inception cohort study.","authors":"Ameenat Lola Solebo, Salomey Kellett, Eibhlin McLoone, Harry Petrushkin, Jose Gonzalez-Martin, Jane Ashworth, Jessy Choi, Rachel F Pilling, Kate Armon, Kishore Warrier, Srilakshmi M Sharma, Jugnoo S Rahi","doi":"10.1136/bjo-2024-326674","DOIUrl":"10.1136/bjo-2024-326674","url":null,"abstract":"<p><strong>Background: </strong>We aimed to provide, through the Uveitis in Childhood National Cohort Study, population-based evidence on incidence, distribution and disease characteristics for childhood onset non-infectious uveitis.</p><p><strong>Methods: </strong>Eligible children and young people (<18 years) were those newly diagnosed with non-infectious uveitis between 1 March 2020 and 28 February 2023. Cases were identified and recruited through passive surveillance across a multicentre network. Descriptive analysis of demographic, socioeconomic and clinical characteristics at diagnosis is reported alongside incidence rates, relative rates by region and sociodemographic patterning.</p><p><strong>Results: </strong>468 cases were identified, providing a minimal national disease incidence of 1.89/100 000 (95% CI 1.72 to 2.07). Among the 255 children recruited, anterior uveitis was predominant (76.9%) and 65% of cases were bilateral. Peak incidence was at 11-15 years. Children resident in deprived areas and those from non-White ethnic backgrounds were over-represented (28% and 31% of the cohort). One in seven children (15%) had a diagnosis of juvenile idiopathic arthritis (JIA), and 5% had tubulointerstitial nephritis. Although bilaterally poor vision was uncommon (16.8%), 44.3% had lost some vision in at least one eye.</p><p><strong>Conclusions: </strong>There is a need to reconsider how best to deliver paediatric rheumatological and eye care that meets the needs of young people, as well as young children, with uveitis. The predominance of non-JIA-related uveitis calls for a shift in focus. There appears to be socioeconomic drivers of disease risk, which are worthy of future exploration and which have implications on the delivery of care for this chronic and blinding disease.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398302","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":"Risk factors for rapid axial length growth in a prospective cohort study of 3-year to 9-year-old Chinese children.","authors":"Yanze Yu, Hao Chen, Zhe Zhang, Yuhao Ye, Yang Shen, Ye Xu, Ke Zheng, Xiaoying Wang, Yingnan Jia, Xingtao Zhou, Jing Zhao","doi":"10.1136/bjo-2024-326261","DOIUrl":"10.1136/bjo-2024-326261","url":null,"abstract":"<p><strong>Aims: </strong>To identify factors contributing to rapid axial length (AL) growth in children aged 3-9 years.</p><p><strong>Methods: </strong>Four thousand four hundred thirty-five children were followed from 2019 to 2022. AL and corneal curvature were measured using an IOLMaster 500, while refractometry and visual acuity were also assessed. Baseline data included demographics and parental myopia status, with annual updates on height, weight and behavioural factors. Latent class growth model was used to discover AL trajectories, whereas multiple logistic regression was used to identify determinants of rapid AL elongation.</p><p><strong>Results: </strong>For all participants, baseline age and parental myopia influenced AL growth. Specifically, children aged 3-6 years exhibited faster AL elongation when engaging in persistent excessive homework time (OR, 2.86, 95% CI 1.31 to 6.95) and near-work activities (OR, 2.13, 95% CI 1.12 to 4.10). For the 7-9-year group, the risk factors of rapid AL growth included being female (OR, 2.05, 95% CI 1.45 to 2.90) and need myopia correction at baseline (OR, 3.19, 95% CI 2.02 to 5.02). Notably, actively engaging in outdoor activities had a protective effect in the 7-9-year group (OR, 0.65, 95% CI 0.43 to 0.97).</p><p><strong>Conclusions: </strong>This study delineates AL growth trajectories in children aged 3-9 years and highlights distinct risk factors for rapid AL growth. These findings underscore the necessity of implementing age-specific strategies for myopia prevention and control.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073965","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":"Evaluating lipid-lowering drug targets for full-course diabetic retinopathy.","authors":"Jiahui Cao, Ting Su, Shuilian Chen, Zijing Du, Chunran Lai, Kaiyi Chi, Qinyi Li, Shan Wang, Qiaowei Wu, Yunyan Hu, Ying Fang, Yijun Hu, Zhuoting Zhu, Yu Huang, Xiayin Zhang, Honghua Yu","doi":"10.1136/bjo-2024-325771","DOIUrl":"10.1136/bjo-2024-325771","url":null,"abstract":"<p><strong>Background: </strong>Implementing lipid control in patients with diabetes is regarded as a potential strategy for halting the advancement of diabetic retinopathy (DR). This study seeks to use Mendelian randomisation (MR) to assess the causal relationship between lipid traits and lipid-lowering drug targets and full-course DR (background DR, severe non-proliferative DR (NPDR) and proliferative DR (PDR)).</p><p><strong>Methods: </strong>A two-sample MR and drug target MR to decipher the causal effects of lipid traits and lipid-lowering drug targets on full-course DR, including background DR, severe NPDR and PDR, was conducted in the study. Genetic variants associated with lipid traits and genes encoding the protein targets of lipid-lowering drugs were extracted from the Global Lipids Genetics Consortium and UK Biobank. Summary-level data of full-course DR are obtained from FinnGen.</p><p><strong>Results: </strong>No significant causal relationship was found between lipid traits and full-course DR. However, in drug target MR analysis, peroxisome proliferator-activated receptor gamma (PPARG) enhancement was associated with lower risks of background DR (OR=0.12, p=0.005) and PDR (OR=0.25, p=0.006). Additionally, mediation MR analysis showed that lowering fasting insulin (p=0.015) and HbA1c (p=0.005) levels mediated most of the association between PPARG and full-course DR.</p><p><strong>Conclusions: </strong>This study reveals PPARG may be a promising drug target for full-course DR. The activation of PPARG could reduce the risk of full-course DR, especially background DR and PDR. The mechanism of the PPARG agonists' protection of full-course DR may be dependent on the glucose-lowering effect.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122203","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":"Associations between a healthy lifestyle score and retinal neurovascular health.","authors":"Xiaomin Zeng, Ruiye Chen, Xiayin Zhang, Ting Su, Yaxin Wang, Yijun Hu, Xianwen Shang, Danli Shi, Honghua Yu","doi":"10.1136/bjo-2024-326184","DOIUrl":"10.1136/bjo-2024-326184","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the associations between a healthy lifestyle score and retinal neurovascular health, and explore whether lower inflammation levels mediate these associations.</p><p><strong>Methods: </strong>This study is based on the UK Biobank. The healthy lifestyle score ranged from 0 to 6 and comprised physical activity, diet, sleep duration, smoking status, alcohol consumption and bodyweight. Outcomes included retinal diseases (age-related macular degeneration (AMD) and retinal vascular occlusion (RVO)) from hospital admission records (378 648 participants), retinal vascular metrics from retinal photography (32 226 participants) and retinal neural metrics from optical coherence tomography (42 557 participants). An INFLA-score was used to characterise inflammation levels.</p><p><strong>Results: </strong>Participants with better healthy life score (scored from 5 to 6) were associated with a 29% lower risk of AMD, 25% lower risk of RVO, 2% increase in artery-to-vein ratio (AVR), 0.22 µm increase in central retinal artery equivalent, 0.36 µm decrease in central retinal vein equivalent (CRVE), 0.004 increase in fractal dimension, 0.38 µm increase in retinal nerve fibre layer, 0.69 µm increase in ganglion cell-inner plexiform layer (GCIPL) and 0.35 µm increase in photoreceptor segment (PS) compared with those with worst lifestyle score (scored from 0 to 1) (all p_trend<0.01). In addition, INFLA-score partially mediated the associations between healthy lifestyle score and increased risk of AMD (mediated proportion (MP): 14.8%), higher AVR (MP: 12.76%), narrower CRVE (MP: 24.49%), thicker GCIPL (MP: 4.97%) and thicker PS (MP: 26.86%).</p><p><strong>Conclusion: </strong>Great adherence to a healthier lifestyle was associated with better retinal health in a dose-response manner. Lower inflammation partially mediated the association between a healthy lifestyle score and retinal health.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390155","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":"Inflammation and patient satisfaction in micropulse versus continuous wave transscleral cyclophotocoagulation.","authors":"Leonie Franziska Keidel,Franziska Eckardt,Matthias Nobl,Siegfried Priglinger,Marc Mackert","doi":"10.1136/bjo-2024-326773","DOIUrl":"https://doi.org/10.1136/bjo-2024-326773","url":null,"abstract":"BACKGROUND/AIMSThis work aims to clarify whether micropulse transscleral cyclophotocoagulation (MPCPC) is gentler in terms of postoperative inflammation and is better tolerated compared with continuous wave cyclophotocoagulation (CWCPC).METHODSProspective, randomised controlled, interventional, single-centre trial performed at the Ludwig Maximilians University Munich from January 2020 to July 2023. In all patients, a laser flare meter was used to measure anterior chamber flare (ACF). Central macular thickness (CMT) was assessed using optical coherence tomography. To quantify pain perception and quality of life (QoL), patients completed the Visual Analogue Scale (VAS) and the Glaucoma Activity Limitation 9 questionnaire.RESULTS60 eyes of 60 patients were included, with 30 eyes in the MPCPC group and 30 eyes in the CWCPC group. A significantly higher increase in ACF was found after CWCPC as compared with MPCPC at 1 day (p=0.004) and 1 week after surgery (p=0). ACF values equalised at week 6 (p=0.270) and month 3 (p=0.610). The increase in ACF at week 1 did not show a significant correlation with the final decrease in intraocular pressure (IOP, p=0.465). Moreover, the CWCPC group showed a markedly higher increase in CMT (165.5 (15-354) µm vs 55.8 (24-141) µm). VAS and QoL scores did not show to be significantly different.CONCLUSIONSCompared with MPCPC, patients treated with CWCPC presented with more marked ACF only in the early postoperative period. ACF did not correlate with final IOP. CWCPC and MPCPC are equally well tolerated in terms of pain perception and QoL, but CWCPC may cause more severe inflammatory macular oedema.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"17 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849342","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":"Vision-related quality of life impact of age-related macular degeneration in older adults aged 60–100 years: a cross-sectional study","authors":"Tai Anh Vu, Eva K Fenwick, Ryan E K Man, Sahil Thakur, Anna C S Tan, Chui Ming Gemmy Cheung, Preeti Gupta, Ecosse Luc Lamoureux","doi":"10.1136/bjo-2024-325713","DOIUrl":"https://doi.org/10.1136/bjo-2024-325713","url":null,"abstract":"Background We evaluated the prevalence of age-related macular degeneration (AMD) and its interplay with age in influencing vision-related quality of life (VRQoL) in older Asians. Methods We included 2361 participants aged 60–101 years from the Population Health and Eye Disease Profile in Elderly Singaporeans cross-sectional study (2017–2022). Early and late AMD were graded using the modified Wisconsin grading system. VRQoL was assessed using Rasch-transformed overall, visual functioning and emotional well-being scores of the Brief Impact of Visual Impairment questionnaire. We calculated the prevalence of AMD and used multivariable regression models to assess the associations between AMD and age on VRQoL. VRQoL reduction was deemed clinically meaningful if ≥0.5 SD of the cohort’s baseline VRQoL scores. Results The overall prevalence of any, early and late AMD was 6.2%, 4.4% and 1.8%, respectively. The age-specific prevalence increased progressively with age; that is, any AMD (4.1%, 7.2%, 12.9%), early AMD (3.0%, 4.7%, 9.3%) and late AMD (1.1%, 2.5%, 3.5%) across the three age groups (60–79, 70–79 and 80+), respectively. Participants aged ≥80 with late AMD experienced 30.1%, 21.0% and 29.7% poorer overall, visual functioning and emotional well-being, respectively (all p≤0.001), compared with those aged 60–79 without AMD. Importantly, only those aged ≥80 with late AMD demonstrated both statistically and clinically meaningful VRQoL reductions. Conclusions AMD is prevalent in ageing Asians and has a substantial impact on visual functioning and emotional well-being. Our findings support early detection of declining visual functioning and mental health and strategies to prevent progression to late-stage AMD in older patients. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"67 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841098","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}