British Journal of Ophthalmology最新文献

{"title":"Sleep disturbance and incident depressive symptoms in patients with glaucoma: a longitudinal study of the LIGHT cohort.","authors":"Tadanobu Yoshikawa, Kenji Obayashi, Kimie Miyata, Hironobu Jimura, Keigo Saeki, Nahoko Ogata, Satoru Kase","doi":"10.1136/bjo-2026-330121","DOIUrl":"https://doi.org/10.1136/bjo-2026-330121","url":null,"abstract":"<p><strong>Aims: </strong>To investigate whether baseline sleep disturbance is associated with an increased risk of incident depressive symptoms in patients with glaucoma.</p><p><strong>Methods: </strong>In our prospective cohort study, a total of 120 patients with glaucoma who had no depressive symptoms at baseline (mean age 70.1 years) were included. Depressive symptoms, defined as a Geriatric Depression Scale score of 6 or greater, were assessed at baseline and at annual follow-up visits. Sleep disturbance was defined as a Pittsburgh Sleep Quality Index score of 6 or greater.</p><p><strong>Results: </strong>During a median follow-up of 3.94 years, 29 of 120 patients developed depressive symptoms. Kaplan-Meier analysis with the log-rank test showed a higher cumulative incidence of depressive symptoms in the group with baseline sleep disturbance than in the group without sleep disturbance (p=0.021). In Cox proportional hazards models, sleep disturbance was associated with an increased risk of incident depressive symptoms (HR 2.32; 95% CI 1.11 to 4.83). Results remained consistent after adjustment for potential confounders, including visual acuity (HR 3.03; 95% CI 1.25 to 7.33). A significant interaction was observed between sleep disturbance and glaucoma severity in relation to incident depressive symptoms (p=0.021). An association between sleep disturbance and incident depressive symptoms was observed in the non-severe glaucoma group (p<0.001), whereas no significant association was found in the severe glaucoma group.</p><p><strong>Conclusions: </strong>Baseline sleep disturbance was independently associated with a higher risk of incident depressive symptoms in patients with glaucoma, irrespective of visual impairment.</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":"148788406","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":"Malignant melanocytic lesions in clinically suspected pterygium.","authors":"Rozina Ida Hajdu, Paola Kammrath Betancor, Othmane Touirssa, Claudia Auw-Haedrich, Thomas Reinhard, Simone Nuessle","doi":"10.1136/bjo-2025-329171","DOIUrl":"10.1136/bjo-2025-329171","url":null,"abstract":"<p><strong>Aims: </strong>To determine the prevalence and clinicopathological features of malignant melanocytic lesions in specimens clinically diagnosed as pterygia.</p><p><strong>Methods: </strong>This retrospective study analysed all conjunctival specimens submitted with the clinical diagnosis 'pterygium' to the ophthalmic pathology laboratory of the Eye Center, University of Freiburg, Germany, between August 1999 and August 2024. Specimens that unexpectedly revealed a histopathological diagnosis of malignant melanocytic lesions were further reviewed for their clinical and pathological characteristics.</p><p><strong>Results: </strong>Among 2298 clinically presumed pterygia, seven specimens (0.30%) harboured a malignant melanocytic lesion: four (0.17%) were invasive conjunctival melanomas and three (0.13%) were high-grade conjunctival melanocytic intraepithelial lesions (C-MIL). Three of four melanomas were amelanotic or hypomelanotic (75%) or exhibited atypical temporal localisation (75%).</p><p><strong>Conclusion: </strong>Malignant melanocytic lesions, though rare, may arise within or mimic pterygia. Their often amelanotic presentation can complicate clinical recognition. Routine histopathological evaluation of all excised pterygia is therefore essential to detect unexpected malignancies as conjunctival melanoma C-MIL.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"997-1001"},"PeriodicalIF":4.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302627","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":"Trauma-related eye removal is associated with increased psychiatric morbidity compared to other surgical indications: a retrospective cohort study.","authors":"Natalia Davila, Chloe Shields, Tejus Pradeep, Samantha Mclaughlin, Brian Wong, Wendy W Lee","doi":"10.1136/bjo-2025-328283","DOIUrl":"10.1136/bjo-2025-328283","url":null,"abstract":"<p><strong>Background/aims: </strong>To evaluate psychiatric outcomes following enucleation or evisceration (EE) and determine whether these outcomes differ by the underlying aetiology related to surgery, including trauma, blind painful eye, infection and malignancy.</p><p><strong>Methods: </strong>This retrospective cohort study utilised the TriNetX Research Network, analysing deidentified records of 20 109 patients who underwent EE. Psychiatric outcomes were compared with 325 108 patients who underwent other major ocular surgeries. Patients were propensity-score matched, and EE cases were stratified into trauma, blind painful eye, infection or malignancy cohorts. Outcomes included new diagnoses of depression, anxiety, stress and adjustment disorders, substance use disorders and new prescriptions of antidepressants or anxiolytics within 1 year. Predictors of psychiatric outcomes were evaluated using the Cox proportional hazards models at 3 years postindex.</p><p><strong>Results: </strong>Compared to matched controls, the EE cohort had higher rates of antidepressant use (risk ratio, RR 1.14; 95% CI, 1.04 to 1.25; p<0.01) and anxiolytic use (RR 1.15; CI, 1.07 to 1.25; p<0.01), despite similar diagnostic rates of depression. Among subgroups, trauma-related EE was uniquely associated with elevated risk of depression (RR 1.85; CI, 1.06 to 3.21; p=0.03), antidepressant use (RR 2.18; CI, 1.45 to 3.26; p<0.01), anxiolytic use (RR 1.63; CI, 1.13 to 2.33; p<0.01) and substance use disorders (RR 2.04; CI, 1.10 to 3.79; p=0.02). Trauma remained an independent predictor of depression after adjusting for psychiatric history and covariates (HR 1.34; CI, 1.11 to 1.62; p<0.01).</p><p><strong>Conclusion: </strong>Psychiatric morbidity following eye removal is influenced by related surgical aetiology. Trauma-related EE carries a distinctly higher psychiatric burden, supporting the need for targeted mental health screening and intervention in this vulnerable subgroup.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1083-1089"},"PeriodicalIF":4.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164074","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 and treatment patterns of acute retinal necrosis: a nationwide population-based cohort study.","authors":"Masahiro Akada, Masayuki Hata, Yuki Muraoka, Kenji Ishihara, Shin Kadomoto, Hiroaki Ueshima, Hiroshi Tamura, Akitaka Tsujikawa, Masahiro Miyake, Yoshihiko Usui","doi":"10.1136/bjo-2025-328609","DOIUrl":"10.1136/bjo-2025-328609","url":null,"abstract":"<p><strong>Aims: </strong>To quantify nationwide incidence and contemporary treatment patterns of acute retinal necrosis (ARN).</p><p><strong>Methods: </strong>Retrospective cohort using Japan's National Database of Health Insurance Claims and Specific Health Checkups, which covers >95% of claims. New-onset ARN (2016-2022) was identified by ARN diagnostic codes plus antiviral therapy. Annual, age-specific and sex-specific incidence rates used governmental denominators; age-standardised rates used the WHO world standard. Surgical management (vitreoretinal surgery, silicone oil (SO)/perfluorocarbon (PFC) use, glaucoma surgery) was assessed up to 2 years after diagnosis.</p><p><strong>Results: </strong>Among 586 incident cases (313 men, 273 women), crude incidence was 0.066 (95% CI 0.061 to 0.072) per 100 000 person-years; the age-standardised rate was 0.040 per 100 000 person-years. Incidence rose with age, peaking at 70-74 years, and was consistently higher in men than in women. Vitreoretinal surgery occurred in 42.4% by 30 days and 59.4% by 365 days after diagnosis; 25.1% underwent ≥2 procedures within 1 year. SO or PFC was used in 40.8% by 1 year. Glaucoma surgery was uncommon (<2% by 2 years).</p><p><strong>Conclusion: </strong>In the largest population-based study of ARN to date, nationwide incidence in Japan closely matched prior UK estimates, suggesting cross-system consistency in ARN epidemiology. Management was characterised by early, intensive surgery with frequent tamponade use and substantial reoperation, informing clinical triage and resource planning for this rare, vision-threatening condition.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1064-1069"},"PeriodicalIF":4.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177946","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":"Aetiology, characteristics and workup of early onset high myopia.","authors":"Hyeck-Soo Son, Anthony Zeng, Veronica Peotta Jacobsen, Grant Welk, Ava Niknahad, Joel VandeLune, Tara Lynn Bragg, Luke Zhao, Maria Ludovica Ruggeri, Arlene V Drack, Alina V Dumitrescu, Jefferson J Doyle","doi":"10.1136/bjo-2025-329097","DOIUrl":"10.1136/bjo-2025-329097","url":null,"abstract":"<p><strong>Background: </strong>Early-onset high myopia (eoHM) associates with multiple ocular and systemic disorders. This study evaluates the repertoire and relative prevalence of these disorders in a tertiary care setting, parses them by eoHM and other characteristics and evaluates the utility of diagnostic workup.</p><p><strong>Methods: </strong>We performed a retrospective analysis of eoHM cases seen at two US eye centres from 2012 to 2022. eoHM was defined as a myopic refraction requiring glasses when ≤2 years of age and/or a refraction greater than -6D by 6 years of age. We reviewed the extent and outcome of workup, including ocular examination, imaging, electrophysiology, systemic evaluation and genetic testing.</p><p><strong>Result: </strong>Of 407 patients with eoHM, 39% had an associated ocular disorder, 21% had a systemic disorder and 40% had apparently isolated eoHM (ie, no associated condition). Patients with associated disorders often reported typical presenting complaints but were more likely to be seen earlier in life, to possess severe, symmetric or very asymmetric eoHM and to display other stigmata of visual dysfunction. Patients with connective tissue disorders and select inherited retinal disorders had the most severe and symmetric eoHM compared with other conditions or isolated cases. Electroretinography and genetic testing were critical workup components.</p><p><strong>Conclusions: </strong>eoHM frequently associates with a wide array of ocular and systemic disorders and may display distinct clinical characteristics depending on the associated condition. Awareness of the range of disorders that present with eoHM, key distinguishing characteristics, the role of timely and targeted workup and the importance of an accurate diagnosis are key considerations.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1036-1044"},"PeriodicalIF":4.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302605","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":"Patient perceptions of artificial intelligence in ophthalmology: a cross-sectional survey study.","authors":"Angela McCarthy, Loaah Eltemsah, Allison Cui, Meredith E Diamond, Jedrzej Golebka, Kaveri A Thakoor, Lora R Dagi Glass","doi":"10.1136/bjo-2025-328498","DOIUrl":"10.1136/bjo-2025-328498","url":null,"abstract":"<p><strong>Background/aims: </strong>Patients have largely been excluded from discussions on the use of their health data in developing medical artificial intelligence (AI), despite being directly affected by its integration into care. This study assessed ophthalmology patients' perspectives on AI to inform patient-aligned development and implementation.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey across ophthalmology clinics in a large academic hospital system in New York City. Consecutive patients were approached in waiting rooms by a research coordinator to maximise sociodemographic diversity and minimise bias from digital literacy or access. The survey, developed by experts in AI, ethics, ophthalmology and survey methodology, was administered via paper and Qualtrics. It addressed attitudes towards AI in clinical scenarios, willingness to share various types of personal data for AI model development and understanding of AI in ophthalmology.</p><p><strong>Results: </strong>Among 403 respondents, 67% reported a low or no understanding of AI, and 71% expressed interest in learning more. Patients prioritised physician involvement and transparency. Comfort decreased with task complexity: highest for screening, lower for diagnosis and lowest for treatment/surgery. For model development, patients were more comfortable sharing de-identified optical coherence technology or lab data than facial images or genetic data. 90% felt consent was always necessary when using personal data to train AI models.</p><p><strong>Conclusions: </strong>These findings highlight the need for patient education and robust data consent protocols. Implementing an opt-out system for retrospective data use may enhance trust while supporting innovation. Integrating patient perspectives into AI governance can foster trust and transparency in ophthalmology and beyond.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1097-1102"},"PeriodicalIF":4.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302612","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":"Biomarker changes of choroidal architecture preceding myopia onset in Chinese school children: a 3-year prospective cohort study.","authors":"Hao Wu, Yuan Wang, Xiang Li, Mengqi Liu, Yuan Lu, Mengxin Liu, Xue Rui, Yue Sun, Jia Qu, Xiangtian Zhou","doi":"10.1136/bjo-2025-328308","DOIUrl":"10.1136/bjo-2025-328308","url":null,"abstract":"<p><strong>Background/aims: </strong>To characterise the temporal dynamics of choroidal changes relative to myopia onset and determine their associations with myopia onset in school children.</p><p><strong>Methods: </strong>The 3-year prospective cohort study consisted of 180 emmetropic school-children. Cycloplegic auto-refractions were performed annually. Choroidal images acquired via swept-source optical coherence tomography until myopia onset were analysed. Choroidal architecture was characterised based on submacular choroidal thickness (ChT), choroidal vascularity index (CVI), luminal area (LA), stromal area (SA) and total choroidal area (TCA) measurements. Time to myopia onset was defined as the first annual follow-up visit with spherical equivalent ≤-0.50 dioptres.</p><p><strong>Results: </strong>A total of 165 participants (330 eyes, 91.7%) who completed at least one annual follow-up were included. During 36 months, 168 eyes of 100 participants developed myopia. Refractive shift and axial elongation showed significant non-linear trends in which they accelerated dramatically approximately 2 years prior to myopia onset. Notably, ChT, as well as CVI, LA, SA and TCA, exhibited significant linear declines throughout the 3 years when these eyes progressed to myopia, whereas they remained unchanged in persistent non-myopic eyes. Multivariable accelerated failure time models showed that a greater decline rate of these choroidal parameters (per SD) shortened the time to myopia onset, with time ratios ranging from 1.26 to 1.76. The area under receiver-operating characteristic curves for annual choroidal changes effectively distinguished incident myopia (0.83-0.89).</p><p><strong>Conclusions: </strong>Alterations in choroidal architecture are an early indicator for the disruption of normal emmetropisation and the onset of myopia.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1012-1020"},"PeriodicalIF":4.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197521","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":"Outcome reporting bias in ophthalmology clinical trials between 2014 and 2023.","authors":"Xiaole Li, Marko Tien, Ryan S Huang, Angelica Hanna, Shrey Acharya, Adrien Lusterio, Han Hsiao, Brendan Tao, Jim Shenchu Xie, Edward Margolin","doi":"10.1136/bjo-2025-328466","DOIUrl":"10.1136/bjo-2025-328466","url":null,"abstract":"<p><strong>Background: </strong>Outcome-reporting bias (ORB), characterised by selective outcome reporting, may exaggerate intervention efficacy and safety, compromising clinical guidelines and patient care. This cross-sectional analysis investigated the prevalence and extent of ORB in seminal ophthalmic randomised controlled trials (RCTs).</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched Embase, MEDLINE and CENTRAL for ophthalmic RCTs published in the 10 highest-impact ophthalmic and general medical journals from 2014 to 2023. Outcomes were incompletely reported if they lacked sufficient data for meta-analysis and unreported if specified in protocols but absent from publications. Logistic regression evaluated associations between incomplete reporting and trial or journal characteristics. The association between outcome unfavourability (ie, failure to demonstrate superiority, non-inferiority or equivalence) and incomplete reporting was calculated as OR and synthesised into a meta-analysis. Discrepancies between prespecified and published outcomes were examined.</p><p><strong>Results: </strong>Of 9436 records, 260 RCTs met inclusion criteria. Among these, 167 (64.2%) and 124 (47.7%) trials had at least one incompletely reported outcome and unreported outcome, respectively. Unreported outcome was associated with lower 5-year impact factor (adjusted OR (aOR): 1.02, 95% CI 1.00 to 1.05, p=0.04, per 1.0 reduction), receiving only industry funding (OR: 1.98, 95% CI 1.02 to 3.85, p=0.04) or not declaring funding compared to non-industry funding (aOR: 3.52, 95% CI 1.22 to 10.18, p=0.02). Unfavourable outcomes were more likely to be incompletely reported than favourable ones (OR: 3.31, 95% CI 2.41 to 4.56, p<0.001). Outcome discrepancies occurred in 121 trials (46.5%).</p><p><strong>Conclusions: </strong>ORB is prevalent in ophthalmic RCTs. Strengthening adherence to prespecified protocols and improving transparency in reporting are essential.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1090-1096"},"PeriodicalIF":4.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302632","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":"Nationwide age-, sex-, cause-specific burden of blindness and vision impairment in China.","authors":"Xiao Guo, Ruilin Xiong, Jingwei Yao, Huangdong Li, Ziyu Zhu, Yanping Chen, Wenyong Huang, Mingguang He, Wei Wang","doi":"10.1136/bjo-2025-327389","DOIUrl":"10.1136/bjo-2025-327389","url":null,"abstract":"<p><strong>Background: </strong>Despite over 90% of vision impairment (VI) being preventable, in China, a routine screening programme is currently unavailable in primary healthcare. Robust epidemiological evidence is needed to guide national strategies.</p><p><strong>Method: </strong>Using Global Burden of Disease 2021 data, we estimated prevalence, years lived with disability (YLDs), and age-standardized rates of VI by cause and severity. Temporal changes were decomposed into contributions from population growth, ageing, and shifts in age-specific prevalence. Estimated annual percentage changes (EAPCs) assessed trends, and Bayesian age-period-cohort models projected burden to 2040.</p><p><strong>Results: </strong>In 2021, China had 767.4 million (95% UI 576.6 to 1009.3) VI cases, comprising: 324.4 million (237.7 to 435.4) uncorrected presbyopia, 4.1 million (3.4 to 5.0) moderate VI, 46.7 million (39.4 to 55.3) severe VI and 8.6 million (7.0 to 10.2) blindness. Population ageing emerged as the predominant driver, accounting for 164.25% of the cataract-related burden increase. Women had a higher burden than men (53.79% of cases; 54.87% of YLDs), and the burden peaked at older ages. Uncorrected refractive errors and cataracts were the leading aetiologies, constituting 50.65% of moderate VI and 35.08% of blindness. Projections indicate that by 2040, the age-standardised YLD rate for VI may nearly double from 2021 levels, reaching 596.4 (95% UI 72.0 to 1240.4) per 100 000 population.</p><p><strong>Conclusions: </strong>VI is a growing public health challenge in China, driven primarily by ageing. Many cases are preventable, underscoring the need for targeted interventions, particularly among women and older adults.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1002-1011"},"PeriodicalIF":4.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099701","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 outcomes of and a risk score model for moderate-risk to high-risk penetrating keratoplasty.","authors":"Zhewen Zheng, Yangqi Zhang, Wenyan Peng, Xueqin Gong, Jinyu Zhang, Chunxiao Wang, Shiyou Zhou","doi":"10.1136/bjo-2025-328901","DOIUrl":"10.1136/bjo-2025-328901","url":null,"abstract":"<p><strong>Background/aims: </strong>To develop a risk score for moderate-risk to high-risk penetrating keratoplasty (PK) based on various risk factors and use it to stratify grafts.</p><p><strong>Methods: </strong>We collected data on clinical features and survival status from the electronic health records of patients who underwent moderate-risk to high-risk PK between January 2012 and December 2021. Feature selection was performed using multivariate Cox regression analyses. The risk score was derived from the coefficient of variables obtained through the Cox proportional hazards model. The performance of the risk score was assessed using receiver operating characteristic curve analysis. Risk stratification was performed based on the risk scores.</p><p><strong>Results: </strong>The study cohort comprised 2297 eyes (2166 patients) subjected to moderate-risk to high-risk PK. The risk score was derived based on six variables. Each variable was assigned a score of 0, 1, 2 or 3 based on its coefficient. The discriminative ability of this score was robust, achieving an area under the receiver operating characteristic curve of 0.747 in the external validation cohort, which surpassed the predictive performance of any single variable alone. According to the established risk score, patients were stratified into three distinct prognostic subgroups: moderate-risk (0-2 points), high-risk (3-5 points) and extremely high-risk groups (≥6 points). The survival curves across these stratified groups differed significantly (log-rank test, p<0.001).</p><p><strong>Conclusion: </strong>The risk score demonstrated good discriminatory ability for moderate-risk to high-risk PK and can help to further stratify these grafts.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"981-989"},"PeriodicalIF":4.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212126","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}