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.
{"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}
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
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.
{"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}
Manisha Supriya, Mithalesh Kumar Singh, Lata Singh, Shivam Sharma, Rachna Meel, Neiwete Lomi, Seema Sen, Seema Kashyap
Aims The goal of this study is to identify the pathological findings and expression of metabolic markers (GLUT-1, PDK-1 and PGC1α) in the tumour microenvironment of both primary and chemoreduced retinoblastoma (Rb) and to correlate with clinicopathological parameters and patient outcome. Methods 81 prospective cases were included, in which 53 cases underwent primary enucleation and 28 cases received chemotherapy before enucleation. Immunohistochemistry, qRT-PCR and western blotting were performed to evaluate the expression pattern of metabolic markers in primary and chemoreduced Rb. Results Tumour microenvironment and histopathological findings were different for both primary and chemoreduced Rb. Increased immunohistochemical expression of GLUT-1, PDK-1 and PGC1α was found in primary Rb as compared with chemoreduced Rb. mRNA expression was also found to be upregulated in primary Rb compared with chemoreduced. On univariate analysis, the presence of more than one histopathological high-risk factor (HRFs>1) and PDK-1 immunoexpression was statistically significant with overall survival. On prognostication in primary and chemoreduced cases with hypoxia, we found increased HR in cases with retrolaminar ON invasion, presence of more than one HRF, and presence of PDK-1 and PGC-1α immunoexpression. Conclusions This is the first of its kind study predicting a relevant role of the metabolic markers in primary and chemoreduced Rb with prognostic significance. Differential expression of these markers in both groups of Rb is a novel finding and might be an interesting and beneficial target for the management of Rb patients. All data relevant to the study are included in the article or uploaded as supplementary information.
{"title":"Exploring metabolic biomarkers in primary and chemoreduced retinoblastoma with patient outcome","authors":"Manisha Supriya, Mithalesh Kumar Singh, Lata Singh, Shivam Sharma, Rachna Meel, Neiwete Lomi, Seema Sen, Seema Kashyap","doi":"10.1136/bjo-2024-326495","DOIUrl":"https://doi.org/10.1136/bjo-2024-326495","url":null,"abstract":"Aims The goal of this study is to identify the pathological findings and expression of metabolic markers (GLUT-1, PDK-1 and PGC1α) in the tumour microenvironment of both primary and chemoreduced retinoblastoma (Rb) and to correlate with clinicopathological parameters and patient outcome. Methods 81 prospective cases were included, in which 53 cases underwent primary enucleation and 28 cases received chemotherapy before enucleation. Immunohistochemistry, qRT-PCR and western blotting were performed to evaluate the expression pattern of metabolic markers in primary and chemoreduced Rb. Results Tumour microenvironment and histopathological findings were different for both primary and chemoreduced Rb. Increased immunohistochemical expression of GLUT-1, PDK-1 and PGC1α was found in primary Rb as compared with chemoreduced Rb. mRNA expression was also found to be upregulated in primary Rb compared with chemoreduced. On univariate analysis, the presence of more than one histopathological high-risk factor (HRFs>1) and PDK-1 immunoexpression was statistically significant with overall survival. On prognostication in primary and chemoreduced cases with hypoxia, we found increased HR in cases with retrolaminar ON invasion, presence of more than one HRF, and presence of PDK-1 and PGC-1α immunoexpression. Conclusions This is the first of its kind study predicting a relevant role of the metabolic markers in primary and chemoreduced Rb with prognostic significance. Differential expression of these markers in both groups of Rb is a novel finding and might be an interesting and beneficial target for the management of Rb patients. 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":"117 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822730","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}
Purpose The current study evaluated the meibum and lid margin microbiome of eyelids with chalazion and compared it with contralateral uninvolved eyelids and healthy controls. Methods Chalazion contents (group 1) and expressed meibum swabs from the lid margins of seven patients with chalazion (mean age 29±12 years; >6 weeks chalazia duration) and age-matched healthy controls were sequenced using next-generation 16S rDNA V3-V4 variable region sequencing. The meibum from the contralateral eye of patient with chalazion served as sample control (group 2), and healthy individuals served as negative control (group 3). The contents were also plated using conventional culture techniques. Results Meibomian glands expressed thick turbid meibum in the area of chalazion in five out of seven eyelids. Contralateral uninvolved eyelids and healthy control glands were expressible with clear meibum. The mean Schirmer I value was 24.6±4.9 mm. Lid margin and meibum microbiome profiling revealed significant differences between the patients (involved or uninvolved sides) and healthy controls. The predominant phyla were Proteobacteria, Bacteroidota and Actinobacteria in all three groups. Acinetobacter , Moraxella and Paracoccus were the predominant genera in groups 1 and 2. Significant differences were noted in the predominant genera between group 3 versus groups 1 and 2. Principal coordinate analysis revealed overlap between groups 1 and 2, whereas group 3 had a distinct cluster. None of the culture media (for aerobic, anaerobic bacteria and fungus) showed any bacterial growth. Conclusion In patients with unilateral chalazion, involved and uninvolved eyelids share similar lid margin and meibum microbiome but differ from the healthy controls. Data are available upon reasonable request.
{"title":"Meibum and lid margin microbiome in eyes with chalazion: exploring an infectious aetiology","authors":"Swati Singh, Moumi Maity, Kotakonda Arunasri, Sayan Basu","doi":"10.1136/bjo-2024-325988","DOIUrl":"https://doi.org/10.1136/bjo-2024-325988","url":null,"abstract":"Purpose The current study evaluated the meibum and lid margin microbiome of eyelids with chalazion and compared it with contralateral uninvolved eyelids and healthy controls. Methods Chalazion contents (group 1) and expressed meibum swabs from the lid margins of seven patients with chalazion (mean age 29±12 years; >6 weeks chalazia duration) and age-matched healthy controls were sequenced using next-generation 16S rDNA V3-V4 variable region sequencing. The meibum from the contralateral eye of patient with chalazion served as sample control (group 2), and healthy individuals served as negative control (group 3). The contents were also plated using conventional culture techniques. Results Meibomian glands expressed thick turbid meibum in the area of chalazion in five out of seven eyelids. Contralateral uninvolved eyelids and healthy control glands were expressible with clear meibum. The mean Schirmer I value was 24.6±4.9 mm. Lid margin and meibum microbiome profiling revealed significant differences between the patients (involved or uninvolved sides) and healthy controls. The predominant phyla were Proteobacteria, Bacteroidota and Actinobacteria in all three groups. Acinetobacter , Moraxella and Paracoccus were the predominant genera in groups 1 and 2. Significant differences were noted in the predominant genera between group 3 versus groups 1 and 2. Principal coordinate analysis revealed overlap between groups 1 and 2, whereas group 3 had a distinct cluster. None of the culture media (for aerobic, anaerobic bacteria and fungus) showed any bacterial growth. Conclusion In patients with unilateral chalazion, involved and uninvolved eyelids share similar lid margin and meibum microbiome but differ from the healthy controls. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"55 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797748","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}
Drew C Baeza, Victor Sanchez, Raquel Goldhardt, Sara S McCoy, Fei Tang, Alan Baer, Robert Fox, Anat Galor
Background To investigate whether certain dry eye (DE) metrics relate to oral and pain manifestations of Sjögren’s disease (SjD). Methods Secondary analysis of the Sjögren’s International Collaborative Clinical Alliance dataset containing 1541 individuals with 2016 American College of Rheumatology/European League Against Rheumatism defined SjD. Binary logistic regression analyses examined which of 13 DE features related to various extraocular metrics. Results The mean age of the population was 52±13.5 years; 45% identified as white and 94% as women. Heterogeneity in DE symptoms and signs was noted in individuals with SjD, with approximately one-third of individuals reporting significant spontaneous and/or evoked pain using various descriptors and indicating certain triggers, and approximately half having low tear production. Similarly, heterogeneity was noted with respect to oral and pain complaints, with extraocular pain symptoms found in approximately one-third of the population. Different ocular phenotypes aligned with different extraocular findings. Specifically, grittiness or scratchiness in the eyes (OR=1.6), blurred vision (OR=1.4) and low tear production (OR=1.8) most closely aligned with oral dryness (‘Does your mouth feel dry?). On the other hand, burning or stinging in the eyes (OR=1.6), discomfort in low humidity (OR=1.2) and the absence of DE signs (normal tear production, OR=0.7; lack of ocular surface staining, OR=0.6) most closely aligned with pain outside the eye (‘Do you experience persistent or frequent burning discomfort?’). Conclusions Our findings suggest heterogeneity in SjD ocular presentations that predict extraocular features of disease and hint at mechanisms that underlie heterogeneity, namely divergent neurosensory processes. Data are available upon reasonable request. See above.
{"title":"The eye as a window to oral and pain symptoms in Sjögren’s disease","authors":"Drew C Baeza, Victor Sanchez, Raquel Goldhardt, Sara S McCoy, Fei Tang, Alan Baer, Robert Fox, Anat Galor","doi":"10.1136/bjo-2024-326748","DOIUrl":"https://doi.org/10.1136/bjo-2024-326748","url":null,"abstract":"Background To investigate whether certain dry eye (DE) metrics relate to oral and pain manifestations of Sjögren’s disease (SjD). Methods Secondary analysis of the Sjögren’s International Collaborative Clinical Alliance dataset containing 1541 individuals with 2016 American College of Rheumatology/European League Against Rheumatism defined SjD. Binary logistic regression analyses examined which of 13 DE features related to various extraocular metrics. Results The mean age of the population was 52±13.5 years; 45% identified as white and 94% as women. Heterogeneity in DE symptoms and signs was noted in individuals with SjD, with approximately one-third of individuals reporting significant spontaneous and/or evoked pain using various descriptors and indicating certain triggers, and approximately half having low tear production. Similarly, heterogeneity was noted with respect to oral and pain complaints, with extraocular pain symptoms found in approximately one-third of the population. Different ocular phenotypes aligned with different extraocular findings. Specifically, grittiness or scratchiness in the eyes (OR=1.6), blurred vision (OR=1.4) and low tear production (OR=1.8) most closely aligned with oral dryness (‘Does your mouth feel dry?). On the other hand, burning or stinging in the eyes (OR=1.6), discomfort in low humidity (OR=1.2) and the absence of DE signs (normal tear production, OR=0.7; lack of ocular surface staining, OR=0.6) most closely aligned with pain outside the eye (‘Do you experience persistent or frequent burning discomfort?’). Conclusions Our findings suggest heterogeneity in SjD ocular presentations that predict extraocular features of disease and hint at mechanisms that underlie heterogeneity, namely divergent neurosensory processes. Data are available upon reasonable request. See above.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775625","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}
This study is the first to review patients using the 3C-classification for ocular cystinosis. The classification shows a high correlation for all markers, symptoms and complications of the disease regularly recorded in practice. The spherical equivalent error increases when adding each subclinical oedema feature determined by the tomography in Barrett Universal II, Hoffer QTS, Barrett True K, and Haigis-L formulae in eyes with Fuchs dystrophy undergoing combined DMEK and cataract surgery. By analysing haplotype-tagging single nucelotide polymorphisms, this study confirmed the association of the HTRA1 gene with myopia in Chinese patients. This suggests shared genetic components between myopia and age-related macular degeneration. In this randomised trial of orthokeratology vs single vision spectacles, sub-clinically weak electrophysiological responses at …
{"title":"At a glance","authors":"Frank Larkin","doi":"10.1136/bjo-2025-327454","DOIUrl":"https://doi.org/10.1136/bjo-2025-327454","url":null,"abstract":"This study is the first to review patients using the 3C-classification for ocular cystinosis. The classification shows a high correlation for all markers, symptoms and complications of the disease regularly recorded in practice. The spherical equivalent error increases when adding each subclinical oedema feature determined by the tomography in Barrett Universal II, Hoffer QTS, Barrett True K, and Haigis-L formulae in eyes with Fuchs dystrophy undergoing combined DMEK and cataract surgery. By analysing haplotype-tagging single nucelotide polymorphisms, this study confirmed the association of the HTRA1 gene with myopia in Chinese patients. This suggests shared genetic components between myopia and age-related macular degeneration. In this randomised trial of orthokeratology vs single vision spectacles, sub-clinically weak electrophysiological responses at …","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"61 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695428","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}
Niccolò Salgari, Angeli Christy Yu, Serena Panariello, Luigi De Rosa, Massimo Busin
Background/aim To investigate the in vivo presence of a natural plane of separation at the pre-Descemet membrane (DM) level in post-penetrating keratoplasty (PK) eyes using confocal microscopy. Methods In vivo confocal microscopy was performed on the corneal stroma of 20 post-PK eyes and 20 keratoplasty-naive healthy control eyes. Patients were recruited from the cornea service of Ospedali Privati Forlì ‘Villa Igea’ between June 2022 and February 2024. The study adhered to the Declaration of Helsinki and was approved by the local ethics committee. Main outcome measures were stromal cell density (SCD) and the pattern of cell distribution. Results Posterior SCD was significantly higher in post-PK eyes compared with controls (387±96 vs 219±30 cell/mm², p<0.0001). A distinct layer densely populated by keratocyte-like cells, corresponding to the last visible row of nuclei before the DM, was observed in post-PK eyes but not in controls. Nuclei of these cells appeared irregularly dispersed or grouped in clusters, and in some cases arranged in columns along a preferred direction. Conclusions A distinct pre-DM layer of keratocyte-like cells is present in post-PK eyes potentially contributing to the previously described natural plane of separation during repeat keratoplasties. Further studies are needed to clarify the origin and clinical implications of this finding. Data are available on reasonable request.
{"title":"In vivo confocal microscopy confirms the presence of new predescemetic cellular layer in post-penetrating keratoplasty buttons","authors":"Niccolò Salgari, Angeli Christy Yu, Serena Panariello, Luigi De Rosa, Massimo Busin","doi":"10.1136/bjo-2024-326878","DOIUrl":"https://doi.org/10.1136/bjo-2024-326878","url":null,"abstract":"Background/aim To investigate the in vivo presence of a natural plane of separation at the pre-Descemet membrane (DM) level in post-penetrating keratoplasty (PK) eyes using confocal microscopy. Methods In vivo confocal microscopy was performed on the corneal stroma of 20 post-PK eyes and 20 keratoplasty-naive healthy control eyes. Patients were recruited from the cornea service of Ospedali Privati Forlì ‘Villa Igea’ between June 2022 and February 2024. The study adhered to the Declaration of Helsinki and was approved by the local ethics committee. Main outcome measures were stromal cell density (SCD) and the pattern of cell distribution. Results Posterior SCD was significantly higher in post-PK eyes compared with controls (387±96 vs 219±30 cell/mm², p<0.0001). A distinct layer densely populated by keratocyte-like cells, corresponding to the last visible row of nuclei before the DM, was observed in post-PK eyes but not in controls. Nuclei of these cells appeared irregularly dispersed or grouped in clusters, and in some cases arranged in columns along a preferred direction. Conclusions A distinct pre-DM layer of keratocyte-like cells is present in post-PK eyes potentially contributing to the previously described natural plane of separation during repeat keratoplasties. Further studies are needed to clarify the origin and clinical implications of this finding. Data are available on reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"58 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143745008","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}
Wan-Ju Annabelle Lee, Shih-Chieh Shao, Miyuki Hsing-Chun Hsieh, Tzu-Chi Liao, Swu-Jane Lin, Edward Chia-Cheng Lai
Aims To assess and compare the risk of adverse renal events among patients with diabetic macular oedema (DME) who were treated with either intravitreal ranibizumab or aflibercept in Taiwan. Methods We conducted a population-based retrospective cohort study and employed a target trial emulation framework using Taiwan’s National Health Insurance Database from 2011 to 2018. Patients aged over 20 years diagnosed with DME and receiving treatment with either intravitreal aflibercept or ranibizumab were included. We applied propensity score methods to ensure balance in the baseline characteristics between the two treatment groups. The primary outcomes were the adverse renal events, specifically acute renal injury and hospitalisation due to renal events. We employed Cox proportional hazards models to estimate the HRs associated with these outcomes. Results A total of 6330 patients receiving ranibizumab and 1258 patients receiving aflibercept were included in this study. The incidence rates of adverse renal events were 102.2 and 138.7 per 1000 person-years for ranibizumab and aflibercept, respectively. Patients treated with intravitreal aflibercept had a significantly higher risk of experiencing a composite of adverse renal events (HR: 1.42; 95% CI: 1.24 to 1.63), compared with those treated with ranibizumab, and specifically also a higher risk of acute kidney injury (HR: 1.32; 95% CI: 1.08 to 1.63) and hospitalisation due to renal events (HR: 1.43; 95% CI: 1.25 to 1.64). Conclusion In comparison to ranibizumab, the intravitreal use of aflibercept was associated with a greater risk of adverse renal events. These findings provide a solid foundation for future studies to validate these results further. Data may be obtained from a third party and are not publicly available. The analytic datasets of this study are available in the NHIRD () and were managed by National Health Research Institutes in Taiwan. Applicants must follow the Computer-Processed Personal Data Protection Law and related regulations. All applications are reviewed for approval of data release.
{"title":"Adverse renal events between ranibizumab and aflibercept in patients with diabetic macular oedema in Taiwan: a comparative cohort study","authors":"Wan-Ju Annabelle Lee, Shih-Chieh Shao, Miyuki Hsing-Chun Hsieh, Tzu-Chi Liao, Swu-Jane Lin, Edward Chia-Cheng Lai","doi":"10.1136/bjo-2024-325509","DOIUrl":"https://doi.org/10.1136/bjo-2024-325509","url":null,"abstract":"Aims To assess and compare the risk of adverse renal events among patients with diabetic macular oedema (DME) who were treated with either intravitreal ranibizumab or aflibercept in Taiwan. Methods We conducted a population-based retrospective cohort study and employed a target trial emulation framework using Taiwan’s National Health Insurance Database from 2011 to 2018. Patients aged over 20 years diagnosed with DME and receiving treatment with either intravitreal aflibercept or ranibizumab were included. We applied propensity score methods to ensure balance in the baseline characteristics between the two treatment groups. The primary outcomes were the adverse renal events, specifically acute renal injury and hospitalisation due to renal events. We employed Cox proportional hazards models to estimate the HRs associated with these outcomes. Results A total of 6330 patients receiving ranibizumab and 1258 patients receiving aflibercept were included in this study. The incidence rates of adverse renal events were 102.2 and 138.7 per 1000 person-years for ranibizumab and aflibercept, respectively. Patients treated with intravitreal aflibercept had a significantly higher risk of experiencing a composite of adverse renal events (HR: 1.42; 95% CI: 1.24 to 1.63), compared with those treated with ranibizumab, and specifically also a higher risk of acute kidney injury (HR: 1.32; 95% CI: 1.08 to 1.63) and hospitalisation due to renal events (HR: 1.43; 95% CI: 1.25 to 1.64). Conclusion In comparison to ranibizumab, the intravitreal use of aflibercept was associated with a greater risk of adverse renal events. These findings provide a solid foundation for future studies to validate these results further. Data may be obtained from a third party and are not publicly available. The analytic datasets of this study are available in the NHIRD (<http://nhird.nhri.org.tw/en/index.html>) and were managed by National Health Research Institutes in Taiwan. Applicants must follow the Computer-Processed Personal Data Protection Law and related regulations. All applications are reviewed for approval of data release.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"183 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723163","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}
Evidence suggests best-corrected visual acuity is not sensitive to subtle vision losses in early disease stages, indicating the need for other tests. Here, we quantified contrast sensitivity in 99 people (20–88 years): 52 with eye diseases (10 with early AMD, 9 diabetics without retinopathy, 22 glaucoma suspects, 11 high myopes) and 47 age-matched healthy controls using a new spatial vision chart (0.28–100% Weber contrasts; 3–60 c/° frequencies). In retinal diseases and healthy ageing, the chart detected frequency-dependent losses; sensitivity was reduced at 3 and 8 c/° in AMD, at 6 and 8 c/° in diabetes, and at all frequencies in myopia and with ageing. Intrasession repeatability was excellent and spatial contrast changes were in accordance with deficits identified previously using complex and time-consuming psychophysical tests. The chart offers a simple, rapid and readily available tool for clinical use to document early visual deficits.
{"title":"Rapid clinical assessment of spatial contrast sensitivity changes in retinal disease and ageing","authors":"Prakash Adhikari, Andrew J. Zele, Beatrix Feigl","doi":"10.1136/bjo-2024-326490","DOIUrl":"https://doi.org/10.1136/bjo-2024-326490","url":null,"abstract":"Evidence suggests best-corrected visual acuity is not sensitive to subtle vision losses in early disease stages, indicating the need for other tests. Here, we quantified contrast sensitivity in 99 people (20–88 years): 52 with eye diseases (10 with early AMD, 9 diabetics without retinopathy, 22 glaucoma suspects, 11 high myopes) and 47 age-matched healthy controls using a new spatial vision chart (0.28–100% Weber contrasts; 3–60 c/° frequencies). In retinal diseases and healthy ageing, the chart detected frequency-dependent losses; sensitivity was reduced at 3 and 8 c/° in AMD, at 6 and 8 c/° in diabetes, and at all frequencies in myopia and with ageing. Intrasession repeatability was excellent and spatial contrast changes were in accordance with deficits identified previously using complex and time-consuming psychophysical tests. The chart offers a simple, rapid and readily available tool for clinical use to document early visual deficits.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"29 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713039","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}
Niklas Hansen, Anders Hvid-Hansen, Flemming Møller, Toke Bek, Dorte Larsen, Nina Jacobsen, Line Kessel
Aim To examine the safety and efficacy of low-dose atropine (0.01% and 0.1% loading dose) after 2-year treatment and 1-year washout in 6-year-old to 12-year-old Danish children with myopia. Methods Investigator-initiated, placebo-controlled, double-blind, randomised clinical trial. Of 124 screened children, 97 were randomised to receive 0.01% low-dose atropine for 24 months (0.01%) or 0.1% low-dose atropine for 6 months, then 0.01% for 18 months (0.1% loading dose) or placebo, followed by a 1-year washout. Altogether, 91 participants completed the study. The primary outcome was myopia progression (axial length (AL) and spherical equivalent refraction (SER)). Secondary outcomes were adverse events, ocular biometrical measurements and treatment responder eyes (myopia progression less than −0.50 diopters (D)). Constrained linear mixed models were constructed with individual eyes nested by participant ID, according to intention-to-treat. The responder analysis used Fisher’s exact test. Significance levels were adjusted for multiple comparisons. Adjusted p values <0.05 were considered significant. Results At 3 years, the mean AL was −0.06 mm (95% CI −0.18; 0.07) and −0.09 mm (95% CI −0.21; 0.04) less compared with placebo in the 0.1% loading dose group and 0.01% group. Mean SER was −0.02 D (95% CI −0.30; 0.26) less and 0.17 D (95% CI −0.11; 0.45) more compared with placebo in the 0.1% loading dose group and 0.01% group. There was no significant group difference in the responder eyes. Conclusion There was no difference in myopia progression between groups following washout. A 6-month 0.1% loading dose did not improve efficacy compared with 0.01%. The 0.1% loading dose showed a rebound effect after dose switching. Data are available upon reasonable request. Data is available upon reasonable request from the corresponding author.
{"title":"3-year results of 0.01% and 0.1% loading dose atropine treatment including washout in Danish children with myopia: a placebo-controlled, randomised clinical trial","authors":"Niklas Hansen, Anders Hvid-Hansen, Flemming Møller, Toke Bek, Dorte Larsen, Nina Jacobsen, Line Kessel","doi":"10.1136/bjo-2024-326918","DOIUrl":"https://doi.org/10.1136/bjo-2024-326918","url":null,"abstract":"Aim To examine the safety and efficacy of low-dose atropine (0.01% and 0.1% loading dose) after 2-year treatment and 1-year washout in 6-year-old to 12-year-old Danish children with myopia. Methods Investigator-initiated, placebo-controlled, double-blind, randomised clinical trial. Of 124 screened children, 97 were randomised to receive 0.01% low-dose atropine for 24 months (0.01%) or 0.1% low-dose atropine for 6 months, then 0.01% for 18 months (0.1% loading dose) or placebo, followed by a 1-year washout. Altogether, 91 participants completed the study. The primary outcome was myopia progression (axial length (AL) and spherical equivalent refraction (SER)). Secondary outcomes were adverse events, ocular biometrical measurements and treatment responder eyes (myopia progression less than −0.50 diopters (D)). Constrained linear mixed models were constructed with individual eyes nested by participant ID, according to intention-to-treat. The responder analysis used Fisher’s exact test. Significance levels were adjusted for multiple comparisons. Adjusted p values <0.05 were considered significant. Results At 3 years, the mean AL was −0.06 mm (95% CI −0.18; 0.07) and −0.09 mm (95% CI −0.21; 0.04) less compared with placebo in the 0.1% loading dose group and 0.01% group. Mean SER was −0.02 D (95% CI −0.30; 0.26) less and 0.17 D (95% CI −0.11; 0.45) more compared with placebo in the 0.1% loading dose group and 0.01% group. There was no significant group difference in the responder eyes. Conclusion There was no difference in myopia progression between groups following washout. A 6-month 0.1% loading dose did not improve efficacy compared with 0.01%. The 0.1% loading dose showed a rebound effect after dose switching. Data are available upon reasonable request. Data is available upon reasonable request from the corresponding author.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"35 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677905","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}
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