British Journal of Ophthalmology最新文献

{"title":"Prevalence and associations of spectacle adherence among school children in a multicentre Indian study","authors":"Subeesh Kuyyadiyil, Elesh Jain, Rishi Raj Borah, Pradhnya Sen, Asim Sil, Catherine M Suttle, Nathan Congdon, Sheeladevi Sethu, Gudlavalleti V S Murthy","doi":"10.1136/bjo-2024-326662","DOIUrl":"https://doi.org/10.1136/bjo-2024-326662","url":null,"abstract":"Background/aims To assess adherence to spectacle wear among children attending public and private schools in urban and rural locations in Kerala, Maharashtra, Madhya Pradesh, Tamil Nadu and West Bengal. Methods All schools within a district served by one of six partner hospitals were invited to participate. Vision screening occurred in children aged 5 to 18 years using a pocket vision screener. Children unable to read 0.2 logMar letters (Snellen equivalent approximately 6/9) monocularly, able to read them through a +1.50 DS lens, already wearing spectacles or with ocular complaints or abnormalities were examined on-site by a vision professional. Glasses were provided according to age-specific guidelines and subjective improvement. Adherence was assessed by direct observation at an unannounced follow-up visit. Results Among 31 991 children prescribed glasses at 2145 schools, 29 667 (92.7%) were available at follow-up median of 5.6 months instead of a planned 3-month follow-up. Of these, 19 679 (66.3%) were adherent. Adherence was higher in children with poorer presenting vision, younger age, attending rural or government-supported schools, in areas with lower human development index or wearing spectacles for the first time (all p<0.001) but did not differ by sex (p=0.414). Adherence was higher in children with astigmatism than myopia (p<0.001) but not hyperopia (p=0.455), was similar in the latter two conditions (p=0.903) and decreased with longer follow-up intervals (p<0.05). Conclusion This large study covering a wide geographic area and variety of schools reveals higher wear among children in greatest need of free service: those living in rural, poorer areas, attending government schools and not previously owning glasses. Data are available upon reasonable request. Not Applicable.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"663 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652153","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":"Psychological comorbidity in glaucoma: prevalence and impact of anxiety and depression","authors":"Alexander Christopher Rokohl, Michael Simon, Philomena A Wawer Matos Reimer, Sabrina Knopp, Nicole Hirt, Thomas S Dietlein, Alexandra Lappas","doi":"10.1136/bjo-2025-327650","DOIUrl":"https://doi.org/10.1136/bjo-2025-327650","url":null,"abstract":"Purpose To assess the prevalence of anxiety and depression among individuals diagnosed with glaucoma, using standardised psychometric instruments, to define factors associated with these psychological diseases, and to identify a potential healthcare gap. Methods In this cross-sectional study, 249 patients with glaucoma were assessed using the 7-item Generalised Anxiety Disorder (GAD-7) scale and the Patient Health Questionnaire (PHQ-9). Correlation analyses explored links between psychometric scores, general mental and physical health functioning, vision-related quality of life and biosocial factors. Results Among participants, 1.2% had a prior anxiety diagnosis and 11.2% a depression diagnosis, yet screening revealed higher rates: 42.2% for anxiety and 34.9% for depression, indicating significant underdiagnosis (p<0.001, respectively). PHQ-9 and GAD-7 scores correlated strongly (p<0.001). Higher PHQ-9 scores were linked to poorer mental and physical health functioning as well as lower vision-related quality of life (p<0.001, respectively), female gender, living alone (p=0.02, respectively), younger age and lower income (p=0.01, respectively). Similarly, higher GAD-7 scores were associated with worse mental health functioning and vision-related quality of life (p<0.001, respectively), female gender (p=0.003), reduced physical health functioning (p=0.03) and lower income (p=0.002). Conclusion Anxiety and depression are frequently underdiagnosed in patients with glaucoma, highlighting a significant healthcare gap. The higher prevalence of these conditions in patients with glaucoma compared with the general population underscores the need for routine psychometric screening to enhance detection and management. Bridging this gap calls for an integrated care model that incorporates psychological evaluation and support into standard protocols, enabling comprehensive, patient-centred care tailored to age, gender, vision-related and socioeconomic factors. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652215","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":"Generation of multidisease fundus photographs with code-free platform","authors":"Huiyu Liang, Qi Zhang, Tian Lin, Chenli Hu, Chaoxin Zheng, Xue Yao, Man Chen, Yifan Chen, Yih Chung Tham, Haoyu Chen","doi":"10.1136/bjo-2024-326741","DOIUrl":"https://doi.org/10.1136/bjo-2024-326741","url":null,"abstract":"Purpose To generate fundus photographs of multiple kinds of retinal disease, bypassing the requirement of coding technique. Methods The dataset contained fundus photographs of 10 categories of retinal conditions, with 500 fundus photographs in each category. We randomly divided the collected data into a training set (80%) and a test set (20%). Google Colaboratory was used to implement Pix2Pix to generate fundus photographs for each category. We compared the diagnostic abilities of ophthalmologists on both real and synthetic images. The diagnostic performance of the classification models trained on real, synthetic and combined data sets was also compared. Furthermore, the real and synthesised images were distinguished by ophthalmologists and artificial intelligence (AI) image detection websites. Results Fundus photographs of 10 categories were successfully synthesised using our method. The synthetic images showed slightly higher diagnostic accuracy by the three ophthalmologists than the real images (99.7% vs 98.7%, 98.0% vs 96.0% and 99.7% vs 94.3%; p=0.109). Training ResNet-50 and VGG-19 models with a combination of real and synthetic images resulted in significant improvements in accuracy, achieving 93.7% and 89.3%, respectively. Five residents achieved at least 92.5% accuracy in discriminating between real and synthetic images. In contrast, three AI image detection websites showed limited capability in this task, with a maximum accuracy of 51.2%. Conclusion Pix2Pix on Google Colaboratory can efficiently produce a diverse range of fundus images with typical characters. All data relevant to the study are included in the article or uploaded as supplementary information. The fundus photographs generated in this study have been uploaded to the website (<https://generated-fundus-images.github.io/x/>) for sharing and can be accessed by anyone. The website address is shown in the text.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639752","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":"Application of real-time artificial intelligence to cataract surgery","authors":"Neil Shah, James Wawrzynski, Rohan Hussain, Bharpoor Singh, The Moorfields Cataract AI Study Group, Imanol Luengo, Carole Addis, Santiago Barbarisi, Rahim Mohammadi, Lucy Culshaw, Ellie Johnston, Pinja Haikka, Karen Kerr, Danail Stoyanov, Daniel Lindegger, George Saleh","doi":"10.1136/bjo-2024-326111","DOIUrl":"https://doi.org/10.1136/bjo-2024-326111","url":null,"abstract":"Background/aims Artificial intelligence (AI) in Ophthalmology has yet to be applied to real-time cataract surgery. This work explores a new AI tool, developed for phacoemulsification, and evaluates its potential uses. First, our study aimed to demonstrate the use of AI in phase recognition and analysis of phacoemulsification. Second, to evaluate the application of real-time AI to live cataract surgery. Methods Phase I: surgical video recordings of adult patients undergoing cataract surgery at Moorfields Eye Hospital were captured. The AI, via Touch Surgery Ecosystem, was developed and used to segment surgery into phases based on the International Council of Ophthalmology-Ophthalmology Surgical Competency Assessment Rubric tool. Phase II: having demonstrated the AI’s functionality in phase I, a further group of phacoemulsification patients was recruited into a live surgery study arm. Three auxiliary screens were deployed in the operating theatres, displaying phase detection and phase relevant information in real time. Results Phase I: 192 videos were analysed between March 2020 and March 2021. Average case duration for consultants (n=68), advanced trainees (n=59) and junior trainees (n=65) was 11.18, 17.54 and 21.36 min, respectively. Efficiency benchmarks were determined using the median metric values for advanced trainee and consultant cases, respectively. Phase II: efficiency metrics for 74 cases with screen deployment and 26 without were compared. With real-time AI, consultant surgeons had a significant decrease in case duration. Conclusions We demonstrate the first use of a fully independent AI platform for analysing efficiency metrics in cataract surgery. Real-time AI has the potential to improve operative efficiency and surgical team training. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"97 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639759","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":"Clinical factors predictive of tumour cytogenetics and metastasis in 86 patients with choroidal nevus growth into melanoma (DIP and DOT study)","authors":"Kevin R Card, Alexandra R Zaloga, Eleni K Konstantinou, Carol L Shields","doi":"10.1136/bjo-2024-325703","DOIUrl":"https://doi.org/10.1136/bjo-2024-325703","url":null,"abstract":"Background Choroidal melanoma can arise from malignant transformation of choroidal nevus. The Cancer Genome Atlas, a classification system based on the genetic status of chromosomes 3 and 8, can be used to prognosticate metastasis and death in choroidal melanoma. This study explores the impact that growth rates and clinical/imaging (TFSOM-DIM (To Find Small Ocular Melanoma, Doing IMaging)) risk factors have on cytogenetics, metastasis and death in choroidal nevus which transforms into melanoma. Methods A retrospective study was performed on 86 consecutive patients diagnosed with choroidal nevus with transformation into melanoma. Tumour cytogenetic results and TFSOM-DIM risk factors for transformation at the date of initial presentation (DIP) and date of transformation diagnosis (DOT) were recorded. Cytogenetic testing of tumours was offered to patients at DOT and was performed on tumour samples obtained via fine-needle aspiration biopsy prior to plaque radiotherapy initiation. Results Of 86 patients, 66% were cytogenetically low-risk and 34% were cytogenetically high-risk. At DOT, high-risk tumours possessed more TFSOM-DIM risk factors than low-risk tumours (4.5 vs 3.8, p=0.003). Choroidal nevus with growth in thickness >0.5 mm/year or >20% per year had increased risk for high-risk cytogenetics (relative risk (RR)=1.93, 95% CI 1.09 to 3.43, p=0.027; RR=2.18, 95% CI 1.22 to 3.92, p=0.008, respectively). Choroidal nevus with growth in basal diameter >0.7 mm/year or >10% per year had increased risk for high-risk cytogenetics (RR=2.22, 95% CI 1.25 to 3.93, p=0.007; RR=1.83, 95% CI 1.03 to 3.26, p=0.042, respectively). Conclusions When monitoring patients with choroidal nevus, clinical risk factors are important in estimating risk for transformation into melanoma. We found that thickness growth >0.5 mm/year or >20% per year, as well as basal diameter growth >0.7 mm/year or >10% per year, were all thresholds that demonstrated increased risk for high-risk cytogenetics. Additionally, tumours with a greater number of TFSOM-DIM risk factors by DOT had significantly increased likelihood of high-risk cytogenetics. No data are available.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"153 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639765","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":"Prediction of repeatable glaucomatous visual field defects based on cluster characteristics.","authors":"Jeremy C K Tan, Jack Phu, Katharina Bell, Ashish Agar, Jonathan Crowston, Giovanni Montesano","doi":"10.1136/bjo-2025-327416","DOIUrl":"10.1136/bjo-2025-327416","url":null,"abstract":"<p><strong>Aim: </strong>This study evaluates if characteristics (eg, location, size, volume) of clusters of defects on an initial visual field (VF) test were predictive of a repeatable defect in the subsequent two tests.</p><p><strong>Methods: </strong>Retrospective cohort study of 197 eyes of 103 patients with healthy, suspect or early glaucoma. Using the initial VF pattern deviation probability grid, we defined the number of clusters (≥1 location of p<5%) and associated size (number of adjoining defect locations) and volume (sum of corresponding total deviation values) for each cluster stratified by the four probability levels (ie, p<5%; p<2%; p<1% and p<0.5%).</p><p><strong>Results: </strong>Of 4424 locations with a defect of p<5%, only 1189 (26.9%) were repeatable. The size [area under the receiver operating characteristic curve (AUC) 0.80, CI 0.76 to 0.85)] and volume (AUC 0.80, CI 0.76 to 0.85) of clusters were predictive of a repeatable defect within the cluster. The optimal thresholds for predicting a repeatable location within each cluster at 95% specificity based on initial cluster size were >6 locations at p<5%, >4 locations at p<2%, >3 locations at p<1% and >2 locations at p<0.5%. Defining cluster defects by involvement of central or peripheral rim locations improved the predictive value compared with the entire 24-2 grid.</p><p><strong>Conclusion: </strong>The location, size and volume of clusters of defects on an initial VF test may be predictive of subsequent repeatability. This may help distinguish eyes with a higher risk of repeatable defects.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559283","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":"Adalimumab biosimilars have similar efficacy to originator adalimumab when treating non-infectious uveitis.","authors":"Oren Tomkins-Netzer,Rachael L Niederer,Radgonde Amer,Shaul Sar,Raz Gepstein,Zohar Habot-Wilner,Hana Shyriaieva,Rima Diab,James Brodie,Jamel Corredores,Eliane Rozanes,Shai Cohen,Ofra Barnett-Griness,Sue Lightman,Michal Kramer,Yael Sharon","doi":"10.1136/bjo-2025-327767","DOIUrl":"https://doi.org/10.1136/bjo-2025-327767","url":null,"abstract":"AIMSTo compare the efficacy in achieving and maintaining control of inflammation between adalimumab biosimilars and originator adalimumab as initial biologic treatment among patients with non-infectious uveitis (NIU).METHODSThis is a multicentre retrospective cohort study. Events of uveitis relapse were noted per eye following initiation of adalimumab treatment. Relapses were defined as the clinical diagnosis of intraocular inflammation, requiring an increase or change in local or systemic immunosuppression. Relapse rates and time to first relapse by 12 months were compared between eyes treated with originator adalimumab or a biosimilar.RESULTS260 eyes of 148 patients diagnosed with NIU were treated with either originator adalimumab (n=193, 74.23%) or a biosimilar (n=67, 25.77%). Median follow-up from baseline for patients who did not relapse was 24.0 months (IQR 18.0, 24.0). Uveitis relapses occurred in 97 eyes (37.31%, 76 in the originator adalimumab group and 21 in the biosimilar group). By 12 months, the estimated relapse rate was 24.2% in the originator adalimumab group versus 28.3% in the biosimilar group (relative risk=1.17, 95% CI 0.58 to 1.77). The average time to relapse by 12 months follow-up for the originator adalimumab group was 4.91 months compared with 5.04 months in the biosimilar group (mean difference 0.13 months, 95% CI -1.33 to 1.54 months).CONCLUSIONOur study suggests that by 12 months of use, biosimilar adalimumab agents were not inferior to originator adalimumab in preventing disease relapse among patients with refractory NIU. These results support the use of biosimilar adalimumab for treating NIU.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"36 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612825","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":"Self-reported vision impairment and depressive symptoms among older adults: a longitudinal mediation analysis","authors":"Ziyin Zhao, Shiyu Wang, Nathan Congdon, Xiaochen Ma","doi":"10.1136/bjo-2024-326072","DOIUrl":"https://doi.org/10.1136/bjo-2024-326072","url":null,"abstract":"Background Though vision impairment (VI) is a strong predictor for late-life depression, the underlying mechanisms remain unclear, particularly in low-income and middle-income countries. This study aims to investigate the contribution of underlying pathways in mediating the association between self-reported VI and depression among Chinese older adults. Methods We included three waves of data from the China Health and Retirement Longitudinal Study. Our analytical cohort consists of 7528 participants aged 45 years or older with an average follow-up of 5 years. Mediation analyses using the inverse odds ratio weighting approach were conducted to explore the mediating effects of social engagement, limitations in physical activity, and healthcare access. Results Participants with self-reported VI had 31% higher odds (95% CI of adjusted OR: 1.12, 1.54) of depression than those with normal vision. In the mediation analysis, the mediation effects of social engagement and physical activity were 6.3% and 21.3%, respectively, while the mediation effect via healthcare access did not differ significantly from 0. The cumulative total indirect effects stemming from these three mediating pathways were estimated at β=0.09 (95% CI: 0.04, 0.15), accounting for 26.2% of the total effect. Conclusions Our findings suggest that the association of self-reported VI with depressive symptoms was partially mediated by social engagement and physical activity limitations. Therefore, promoting social engagement and rehabilitation services in activities of daily living (ADL) and instrumental ADL are potential interventions to improve mental health status among visually impaired older adults. Data are available in a public, open access repository. This study is based on publicly available datasets. The health data can be accessed from the website: <http://charls.pku.edu.cn/>.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"109 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603761","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":"Increased clinical risk factors and absence of leucocoria in late-onset retinoblastoma: a comparative cohort study","authors":"Yu Luan, Mingpeng Xu, Jie Yang, Ya Chen, Xuyang Wen, Minglei Han, Renbing Jia, Jiayan Fan, Peiwei Chai","doi":"10.1136/bjo-2025-327750","DOIUrl":"https://doi.org/10.1136/bjo-2025-327750","url":null,"abstract":"Aims To characterise the clinicopathological features, treatment outcomes and prognostic factors in late-onset retinoblastoma (LoRB) (≥5 years) compared to classical-onset cases (<5 years). Methods This retrospective cohort study included 21 cases of LoRB and 84 matched classical-onset cases diagnosed between April 2016 and December 2023 at two tertiary retinoblastoma (RB) centres. Data on clinical presentations, histopathological features, treatment modalities and outcomes were collected and analysed between two groups. A subgroup analysis was performed based on presenting symptoms in the late-onset group. Results During the study period, 21 patients with LoRB were diagnosed, accounting for 5.43% of all RB cases. The median age at diagnosis was 80 months. All late-onset cases presented unilaterally and were in International Intraocular Retinoblastoma Classification groups D and E. Compared with the control group, late-onset patients demonstrated significantly longer diagnostic lag times (p=0.008), a markedly lower rate of leucocoria as the presenting symptom (p<0.001), a higher rate of vitreous seeding (p=0.03) and subretinal fluid (p=0.04), and shorter median globe salvage times (p=0.04). Late-onset patients with atypical onset symptoms experienced longer diagnostic lag times (p=0.05), more group E eyes at diagnosis (p=0.03) and shorter median globe salvage times (p=0.05) compared with those with classical symptoms (leucocoria and strabismus). Conclusion LoRB presents distinct clinical features and more severe manifestations, highlighting the necessity for early recognition and timely intervention of this subtype. Our findings contribute to a more comprehensive understanding of the relationship between the age of onset and RB behaviour. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"4 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603275","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":"Use of patient-reported outcomes in ophthalmology clinical trials between 2014 and 2023","authors":"Xiaole Li, Natalie Chen, Han Hsiao, Angelica Hanna, Moiz Lakhani, Angela T H Kwan, Brendan K Tao, Jim Shenchu Xie, Edward Margolin","doi":"10.1136/bjo-2024-326961","DOIUrl":"https://doi.org/10.1136/bjo-2024-326961","url":null,"abstract":"Background/aims Patient-reported outcomes (PROs) evaluate health and functional status, and PRO measures (PROMs) are standardised tools for measuring PROs. Together, they provide valuable insights into treatment efficacy, safety and practicality not captured by traditional clinical endpoints. This cross-sectional analysis with a systematic search component aims to investigate the use, interpretation and reporting of PROs and PROMs in ophthalmic randomised controlled trials (RCTs). Methods Ophthalmic RCTs published in the top 10 highest impact factor ophthalmic and medical journals between 2014 and 2023 were systematically reviewed. The frequency of PRO inclusion and adherence to Consolidated Standards of Reporting Trials (CONSORT) PRO guidelines was assessed. The relationship between PRO utilisation and study-level and journal-level characteristics was explored with multivariable regression. Results Among 9436 records screened, 333 RCTs met eligibility criteria. Of these, 87 (26.1%) included PROs, and 28 (8.4%) used them as primary outcomes. Most studies (83/87, 95.4%) leveraged PROMs, with ophthalmology-specific tools predominating (73.5%). Minimal important differences (MIDs) were rarely used (2.3%) for PRO interpretation. At least 8/13 CONSORT PRO Extension items were reported in 33.3% studies, and trials with primary PRO endpoints had better adherence (p<0.001). PRO utilisation was less likely in trials with lower 5-year journal impact factor (adjusted OR (aOR) 0.99, 95% CI 0.98 to 1.00, p=0.037) and pharmaceutical compared with health service interventions (aOR 0.15, 95% CI 0.03 to 0.67, p=0.013). Conclusions PRO integration and interpretation remain limited in high-impact ophthalmic RCTs, despite offering a meaningful adjunct to objective endpoints. Future trials should adopt validated and condition-specific PROMs and establish MIDs to enhance interpretation. Data are available on reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"35 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603277","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}