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Iris freckle: a distinct entity. 虹膜雀斑:一个独特的实体。
IF 3.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-22 DOI: 10.1136/bjo-2023-325009
Yağmur Seda Yeşiltaş, Millennia Zhou, Emily C Zabor, Zackery Oakey, Nakul Singh, Ahad Sedaghat, Gabrielle Yeaney, Arun D Singh

Purpose: To report distinctive clinical and imaging features of iris freckles to differentiate them from iris nevi.

Design: Retrospective observational study.

Subjects: 53 patients (277 freckles) with incidental iris freckles and 102 patients (104 nevi) with iris nevi that are either clinically stable or pathologically confirmed.

Methods: Patient data were collected from the Department of Ophthalmic Oncology, Cleveland Clinic, Cole Eye Institute database (2012-2023). Lesion characteristics were recorded from slit-lamp examination descriptions and review of colour photographs. Ancillary imaging features observed using anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) were assessed in patients (where available).

Main outcome measures: Comparison of clinical and imaging features of iris freckles and iris nevi.

Results: A total of 277 iris freckles and 104 iris nevi were analysed. Iris freckles were more frequently bilateral (17%; nevi 0%) and multiple (69%; nevi 2%) and located centrally (89%; nevi 17%) compared with iris nevi (p<0.001). The median freckle largest basal diameter and thickness were 0.8 mm (nevi; 2.1 mm, p<0.001) and 0.04 mm (nevi 1.0 mm, p<0.001), respectively. All iris freckles had irregular margins without any secondary effects compared with iris nevi. Iris freckles appeared flat without effacement of iris folds compared with iris nevi on AS-OCT (p<0.001). Iris freckles were not detectable by UBM. Heat map revealed that freckles demonstrated several features with uniform or near uniform values, whereas nevi demonstrated more variability in values across features.

Conclusions: Iris freckles exhibit specific clinical and imaging features reflective of their characteristic histological composition that support their classification as a distinct entity within the spectrum of iris pigmented lesions.

目的:报告虹膜雀斑的独特临床和影像学特征,以将其与虹膜痣区分开来:设计:回顾性观察研究:53例偶发性虹膜雀斑患者(277个雀斑)和102例临床稳定或病理证实的虹膜痣患者(104个痣):患者数据来自克利夫兰诊所眼科肿瘤部、科尔眼科研究所数据库(2012-2023 年)。根据裂隙灯检查描述和彩色照片审查记录病变特征。对患者使用眼前节光学相干断层扫描(AS-OCT)和超声生物显微镜(UBM)观察到的辅助成像特征进行评估(如有):比较虹膜雀斑和虹膜痣的临床和成像特征:共分析了 277 例虹膜雀斑和 104 例虹膜痣。与虹膜痣相比,虹膜雀斑更常见于双侧(17%;痣 0%)和多发(69%;痣 2%),且位于中心位置(89%;痣 17%)(p结论:虹膜雀斑表现出特殊的临床和影像学特征,反映了其特有的组织学组成,支持将其归类为虹膜色素病变谱系中的一个独特实体。
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引用次数: 0
METAVISION: a novel system for quantifying metamorphopsia in patients with myopic traction maculopathy. METAVISION:一种用于量化近视牵引性黄斑病变患者变形的新型系统。
IF 3.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-22 DOI: 10.1136/bjo-2023-324175
Qi Zhang, Xiujuan Zhao, Xia Huang, Qingxiu Wu, Shida Chen, Yonghao Li, Ping Lian, Lin Lu

Purpose: To develop a novel system for quantifying metamorphopsia in patients with myopic traction maculopathy (MTM) and to explore the metamorphopsia pattern of MTM.

Design: Observational, cross-sectional study.

Methods: We designed a new system.

Results: Of the 445 eyes tested, 188 (42.25%) were deemed by patients to have metamorphopsia impacting their daily lives while 257 (57.75%) were considered to have no metamorphopsia symptoms. The Amsler grid, M-CHARTS and METAVISION tests displayed sensitivities for metamorphopsia of 95.74%, 89.89% and 100%, respectively. The specificities of the Amsler grid, M-CHARTS and METAVISION tests are 100%. The metamorphopsia questionnaire and METAVISION scores were highly consistent (average intraclass correlation coefficient=0.951, p<0.001) and strongly correlated (R=0.879, p<0.001). The METAVISION score was highly correlated with the stages of MTM (R=0.837, p<0.001), whereas there was a moderate correlation between the M-CHARTS M-score and the stages of MTM (R=0.679, p<0.001).

Conclusions: Quantification of metamorphopsia is important and useful for MTM management. The METAVISION is a clinically applicable and comprehensive approach for quantifying metamorphopsia, which can be used in clinical settings.

目的:开发一种新型系统,用于量化近视牵引性黄斑病变(MTM)患者的元认知,并探讨MTM的元认知模式:设计:观察性横断面研究:方法:我们设计了一套新的系统:结果:在接受测试的 445 只眼睛中,188 只(42.25%)被患者认为有影响其日常生活的变形,而 257 只(57.75%)被认为没有变形症状。阿姆斯勒网格、M-CHARTS 和 METAVISION 测试对偏视的敏感度分别为 95.74%、89.89% 和 100%。Amsler网格、M-CHARTS和METAVISION测试的特异性为100%。元认知问卷和 METAVISION 评分高度一致(平均类内相关系数=0.951,p 结论:元认知问卷和 METAVISION 评分高度一致(平均类内相关系数=0.951,p 结论:元认知问卷和 METAVISION 评分高度一致):元认知的量化对 MTM 管理非常重要和有用。METAVISION 是一种适用于临床的、全面的元变态反应量化方法,可在临床环境中使用。
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引用次数: 0
Ophthalmic quality of life in the adult Danish population: an epidemiological study. 丹麦成年人的眼科生活质量:一项流行病学研究。
IF 3.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-22 DOI: 10.1136/bjo-2023-324414
Toke Bek, Bodil Hammer Bech

Background: Ophthalmic quality of life (OQoL) has been investigated in selected parts of general populations and in patients with ocular disease, but OQoL in unselected general populations has not been studied in detail. The present study reports OQoL obtained from a representative sample of the adult Danish population 2020-2022.

Methods: The FORSYN study invited 10 350 citizen representatives for the adult Danish population for a non-mydriatic eye examination and answer the National Eye Institute Visual Function Questionnaire with 39 items in the validated Danish translation. The results from the 3384 (32.7%) persons who participated in the study were weighted on the basis of relevant socio-economic factors, and data were projected to represent the total population. Binocular visual acuity was below 0.1 corresponding to legal blindness in 0.22% of this population.

Results: OQoL was positively correlated with binocular visual acuity up to better than 93 ETDRS letters, negatively correlated with age for persons younger than 60 years of age and again positively correlated with age for persons older than 60 years. OQoL was negatively correlated with increasing ametropia and refractive error above 1 dioptre and encompassed more OQoL parameters for hyperopic than for myopic persons.

Conclusions: The study underlines the benefits of improving visual acuity even within the normal range and of adjusting uncorrected refraction errors in the general population. OQoL is positively correlated with age in older persons independently of visual acuity, sex, refractive power and previous cataract surgery.

背景:眼科生活质量(OQoL)已在部分普通人群和眼科疾病患者中进行了调查,但尚未对未选择的普通人群的 OQoL 进行详细研究。本研究报告了从 2020-2022 年丹麦成年人口的代表性样本中获得的 OQoL:FORSYN研究邀请了10 350名丹麦成年人口的公民代表进行非眼球屈光检查,并回答了国家眼科研究所视觉功能问卷的39个项目,该问卷的丹麦语译文已经过验证。根据相关的社会经济因素,对参与研究的 3384 人(32.7%)的结果进行了加权,并将数据推算为代表总人口的数据。研究结果显示,0.22% 的人双眼视力低于 0.1,相当于合法失明:OQoL 与双眼视力呈正相关,最高可达 93 个 ETDRS 字母,与年龄呈负相关(60 岁以下),与年龄呈正相关(60 岁以上)。OQoL 与屈光度和屈光误差的增加呈负相关,远视者的 OQoL 参数多于近视者:这项研究强调了在正常范围内提高视力和调整普通人群未矫正屈光度误差的益处。老年人的 OQoL 与年龄呈正相关,与视力、性别、屈光力和之前的白内障手术无关。
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引用次数: 0
Improved accuracy of spectral-domain optical coherence tomography and optical coherence tomography angiography for monitoring myopic macular neovascularisation activity. 提高光谱域光学相干断层扫描和光学相干断层血管造影监测近视黄斑新生血管活动的准确性。
IF 3.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-22 DOI: 10.1136/bjo-2023-323374
Danny Siu-Chun Ng, Li Jia Chen, Leo Ka Yu Chan, Fang Yao Tang, Wee-Min Teh, Linbin Zhou, Fiona Chan, Eleanor Sui Sum Lin, Ka Wai Yuen, Wai Kit Chu, Shaheeda Mohamed, Chi Wai Tsang, Xinyuan Zhang, Jason C Yam, Chi-Pui Pang, Timothy Y Y Lai

Background/aims: To evaluate the diagnostic accuracy of spectral-domain optical coherence tomography (SD OCT) combined with OCT angiography (OCTA) for myopic myopic macular neovascularisation (MNV) activity.

Methods: Both eyes of patients with myopic MNV diagnosed with fluorescein angiography (FA), SD OCT and OCTA were assessed by unmasked investigators. The images were deidentified and randomised before graded by masked investigators, who determined the presence of active myopic MNV by using SD OCT together with OCTA without FA and by FA alone, respectively. The findings of masked investigators were compared with unmasked investigators.

Results: 213 eyes of 110 patients comprising 499 imaging episodes were eligible for grading. For diagnosing new-onset myopic MNV without FA, combined use of SD OCT and OCTA had a sensitivity of 0.94, specificity of 0.84 and area under the curve (AUC) of 0.92. FA had a sensitivity of 0.52 (p<0.01), specificity of 0.80 (p=0.38) and AUC of 0.66 (p<0.01). For recurrent myopic MNV, the combination of SD OCT and OCTA had a sensitivity of 0.98, specificity of 0.78 and AUC of 0.88. FA had a sensitivity of 0.50 (p=0.04), specificity of 0.76 (p=0.85) and AUC of 0.63 (p=0.01). Myopic traction maculopathy was more frequently associated with recurrent myopic MNV (p<0.01).

Conclusion: SD OCT with dense volumetric scan was highly sensitive for diagnosing myopic MNV. The addition of OCTA improved the diagnostic specificity without FA. Monitoring of the longitudinal changes on SD OCT and judicious use of FA is a reliable surveillance strategy for myopic MNV.

背景/目的:评估光谱域光学相干断层扫描(SD OCT)结合OCT血管造影(OCTA)对近视眼黄斑新生血管(MNV)活动的诊断准确性:方法:由不戴眼罩的研究人员对通过荧光素血管造影(FA)、SD OCT 和 OCTA 诊断为近视性黄斑新生血管的患者的双眼进行评估。在由蒙面调查员进行分级之前,对图像进行了去身份化和随机化处理,蒙面调查员分别通过使用 SD OCT 和不含 FA 的 OCTA 以及仅使用 FA 来确定是否存在活动性近视 MNV。结果:110 名患者的 213 只眼睛共 499 次成像符合分级条件。在诊断无 FA 的新发近视 MNV 时,联合使用 SD OCT 和 OCTA 的灵敏度为 0.94,特异性为 0.84,曲线下面积(AUC)为 0.92。FA的灵敏度为0.52(p结论:带有致密容积扫描的 SD OCT 对近视 MNV 的诊断高度敏感。在没有 FA 的情况下,增加 OCTA 可提高诊断特异性。监测SD OCT的纵向变化并明智地使用FA是一种可靠的近视MNV监测策略。
{"title":"Improved accuracy of spectral-domain optical coherence tomography and optical coherence tomography angiography for monitoring myopic macular neovascularisation activity.","authors":"Danny Siu-Chun Ng, Li Jia Chen, Leo Ka Yu Chan, Fang Yao Tang, Wee-Min Teh, Linbin Zhou, Fiona Chan, Eleanor Sui Sum Lin, Ka Wai Yuen, Wai Kit Chu, Shaheeda Mohamed, Chi Wai Tsang, Xinyuan Zhang, Jason C Yam, Chi-Pui Pang, Timothy Y Y Lai","doi":"10.1136/bjo-2023-323374","DOIUrl":"10.1136/bjo-2023-323374","url":null,"abstract":"<p><strong>Background/aims: </strong>To evaluate the diagnostic accuracy of spectral-domain optical coherence tomography (SD OCT) combined with OCT angiography (OCTA) for myopic myopic macular neovascularisation (MNV) activity.</p><p><strong>Methods: </strong>Both eyes of patients with myopic MNV diagnosed with fluorescein angiography (FA), SD OCT and OCTA were assessed by unmasked investigators. The images were deidentified and randomised before graded by masked investigators, who determined the presence of active myopic MNV by using SD OCT together with OCTA without FA and by FA alone, respectively. The findings of masked investigators were compared with unmasked investigators.</p><p><strong>Results: </strong>213 eyes of 110 patients comprising 499 imaging episodes were eligible for grading. For diagnosing new-onset myopic MNV without FA, combined use of SD OCT and OCTA had a sensitivity of 0.94, specificity of 0.84 and area under the curve (AUC) of 0.92. FA had a sensitivity of 0.52 (p<0.01), specificity of 0.80 (p=0.38) and AUC of 0.66 (p<0.01). For recurrent myopic MNV, the combination of SD OCT and OCTA had a sensitivity of 0.98, specificity of 0.78 and AUC of 0.88. FA had a sensitivity of 0.50 (p=0.04), specificity of 0.76 (p=0.85) and AUC of 0.63 (p=0.01). Myopic traction maculopathy was more frequently associated with recurrent myopic MNV (p<0.01).</p><p><strong>Conclusion: </strong>SD OCT with dense volumetric scan was highly sensitive for diagnosing myopic MNV. The addition of OCTA improved the diagnostic specificity without FA. Monitoring of the longitudinal changes on SD OCT and judicious use of FA is a reliable surveillance strategy for myopic MNV.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1729-1736"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903687","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}
引用次数: 0
Two-year outcomes of Xen 45 gel stent implantation in patients with open-angle glaucoma: real-world data from the Fight Glaucoma Blindness registry. 开角型青光眼患者 Xen 45 凝胶支架植入术两年后的疗效:来自抗击青光眼致盲登记处的真实数据。
IF 3.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-22 DOI: 10.1136/bjo-2023-325077
Louis Arnould, Elise Balsat, Yohei Hashimoto, Andrew White, George Kong, Hamish Dunn, Leo Fan, Pierre-Henry Gabrielle, Alain M Bron, Catherine P Creuzot-Garcher, Mitchell Lawlor

Objective: To evaluate efficacy and safety outcomes of the Xen 45 gel stent implant over 24 months of follow-up.

Methods: A retrospective analysis of prospectively collected data from the Fight Glaucoma Blindness observational registry. Complete success (CS) was defined as intraocular pressure (IOP) reduction ≥20% from preoperative and an IOP ≤18 mm Hg and ≥6 mm Hg with no secondary procedure at 2 years and without IOP-lowering medications. Qualified success (QS) was defined similarly, allowing the use of IOP-lowering medications.

Results: The Xen 45 gel stent implant was implanted in 646 eyes of 515 patients. Preoperative IOP was 21.4±7.6 (mean±SD) mm Hg on 2.7±1.3 IOP-lowering medication and mean deviation was -10.2±8.4 dB. After 24-month follow-up, IOP was 16.8±7.3 mm Hg (mean reduction of 21.7%) on 1.2±1.4 IOP-lowering medications. CS and QS rates at 24 months were 26% and 48%, respectively. CS and QS were higher in the Xen stand-alone group (33% and 52%, respectively) than in the Xen+cataract group (16% and 42%, respectively). Bleb needling was performed in 28.4% of cases, and 18% underwent a secondary procedure.

Conclusions: The Xen 45 gel stent implant offers acceptable long-term efficacy for the treatment of open-angle glaucoma. However, there is a significant rate of reoperation and needling, and outcomes are less effective if combined with cataract surgery.

目的:评估 Xen 45 凝胶支架植入物 24 个月随访的疗效和安全性:评估 Xen 45 凝胶支架植入物在 24 个月随访期间的疗效和安全性:方法:对抗击青光眼致盲观察登记处前瞻性收集的数据进行回顾性分析。完全成功(CS)的定义是眼压(IOP)比术前降低≥20%,眼压≤18 mm Hg,且≥6 mm Hg,2年内无二次手术,未服用降眼压药物。合格成功(QS)的定义类似,允许使用降眼压药物:结果:515 名患者的 646 只眼睛植入了 Xen 45 凝胶支架。术前使用 2.7±1.3 降眼压药物时,眼压为 21.4±7.6(平均值±SD)毫米汞柱,平均偏差为 -10.2±8.4 分贝。随访 24 个月后,使用 1.2±1.4 种降低眼压药物时,眼压为 16.8±7.3mmHg(平均降低 21.7%)。24个月时的CS和QS率分别为26%和48%。Xen独立组的CS和QS率(分别为33%和52%)高于Xen+白内障组(分别为16%和42%)。28.4%的病例进行了出血针刺,18%的病例进行了二次手术:结论:Xen 45凝胶支架植入体在治疗开角型青光眼方面具有可接受的长期疗效。结论:Xen 45 凝胶支架植入体在治疗开角型青光眼方面具有可接受的长期疗效,但再次手术和针刺的比例较高,而且如果与白内障手术结合使用,疗效较差。
{"title":"Two-year outcomes of Xen 45 gel stent implantation in patients with open-angle glaucoma: real-world data from the Fight Glaucoma Blindness registry.","authors":"Louis Arnould, Elise Balsat, Yohei Hashimoto, Andrew White, George Kong, Hamish Dunn, Leo Fan, Pierre-Henry Gabrielle, Alain M Bron, Catherine P Creuzot-Garcher, Mitchell Lawlor","doi":"10.1136/bjo-2023-325077","DOIUrl":"10.1136/bjo-2023-325077","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate efficacy and safety outcomes of the Xen 45 gel stent implant over 24 months of follow-up.</p><p><strong>Methods: </strong>A retrospective analysis of prospectively collected data from the Fight Glaucoma Blindness observational registry. Complete success (CS) was defined as intraocular pressure (IOP) reduction ≥20% from preoperative and an IOP ≤18 mm Hg and ≥6 mm Hg with no secondary procedure at 2 years and without IOP-lowering medications. Qualified success (QS) was defined similarly, allowing the use of IOP-lowering medications.</p><p><strong>Results: </strong>The Xen 45 gel stent implant was implanted in 646 eyes of 515 patients. Preoperative IOP was 21.4±7.6 (mean±SD) mm Hg on 2.7±1.3 IOP-lowering medication and mean deviation was -10.2±8.4 dB. After 24-month follow-up, IOP was 16.8±7.3 mm Hg (mean reduction of 21.7%) on 1.2±1.4 IOP-lowering medications. CS and QS rates at 24 months were 26% and 48%, respectively. CS and QS were higher in the Xen stand-alone group (33% and 52%, respectively) than in the Xen+cataract group (16% and 42%, respectively). Bleb needling was performed in 28.4% of cases, and 18% underwent a secondary procedure.</p><p><strong>Conclusions: </strong>The Xen 45 gel stent implant offers acceptable long-term efficacy for the treatment of open-angle glaucoma. However, there is a significant rate of reoperation and needling, and outcomes are less effective if combined with cataract surgery.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1672-1678"},"PeriodicalIF":3.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092860","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}
引用次数: 0
12-month outcomes after voretigene neparvovec gene therapy in paediatric patients with RPE65-mediated inherited retinal dystrophy 对RPE65介导的遗传性视网膜营养不良儿科患者进行voretigene neparvovec基因治疗后12个月的疗效观察
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-21 DOI: 10.1136/bjo-2024-326221
Alejandra Daruich, Maxence Rateaux, Emilie Batté, Nathalie de Vergnes, Sophie Valleix, Matthieu P. Robert, Dominique Bremond Gignac
Aims To report main outcomes and complications following voretigene neparvovec (Luxturna) treatment in paediatric patients. Methods Records of patients under the age of 17 treated by subretinal administration of voretigene neparvovec for confirmed biallelic RPE65 -mediated inherited retinal dystrophy were retrospectively reviewed. Best-corrected visual acuity (BCVA) and data from spectral-domain optical coherence tomography, ultra-wide-field fundus imaging and Goldmann visual field (VF) were analysed at 12 months follow-up. Results 12 eyes of six patients (mean age: 7.8 years) were analysed. No intraoperative complications occurred. BCVA significantly improved at 12-month follow-up (mean LogMAR (logarithm of the minimal angle of resolution) BCVA: 1.0±0.8 at baseline vs 0.6±0.3 at 12 months, p=0.001). Mean central macular thickness and central outer nuclear layer thickness did not change at 12 months follow-up. VF V4e isopter did not show significant changes. Postoperatively complications included: elevated intraocular pressure in two eyes of the same patient, a parafoveal lamellar hole at 3 months post-treatment and atrophy on the injection site observed in all eyes except one, which significantly enlarged during 12 months (p=0.008). Conclusions Most paediatric patients treated by voretigene neparvovec showed a significant increase in visual function at 12 months follow-up. None of the postoperative complications prevented gains in visual function. All data relevant to the study are included in the article or uploaded as supplementary information. NA.
目的 报告儿童患者接受 voretigene neparvovec(Luxturna)治疗后的主要疗效和并发症。方法 回顾性审查 17 岁以下患者的记录,这些患者因确诊为双偶性 RPE65 介导的遗传性视网膜营养不良而接受视网膜下注射 voretigene neparvovec 治疗。对随访 12 个月的最佳矫正视力 (BCVA) 以及光谱域光学相干断层扫描、超宽视野眼底成像和戈德曼视野 (VF) 数据进行了分析。结果 对 6 名患者(平均年龄:7.8 岁)的 12 只眼睛进行了分析。术中未出现并发症。随访12个月时,BCVA明显改善(平均LogMAR(最小解像角对数)BCVA:基线时为1.0±0.8,12个月时为0.6±0.3,P=0.001)。黄斑中心厚度和中央核外层厚度在随访 12 个月时没有变化。VF V4e 等轴位无明显变化。术后并发症包括:同一患者的两只眼睛眼压升高,治疗后 3 个月出现眼底板层孔,除一只眼睛外,其他眼睛的注射部位均出现萎缩,且萎缩部位在 12 个月内明显扩大(p=0.008)。结论 大多数接受 voretigene neparvovec 治疗的儿科患者在 12 个月的随访中显示视功能显著增强。术后并发症均未阻碍视功能的提高。与该研究相关的所有数据均包含在文章中或作为补充信息上传。NA.
{"title":"12-month outcomes after voretigene neparvovec gene therapy in paediatric patients with RPE65-mediated inherited retinal dystrophy","authors":"Alejandra Daruich, Maxence Rateaux, Emilie Batté, Nathalie de Vergnes, Sophie Valleix, Matthieu P. Robert, Dominique Bremond Gignac","doi":"10.1136/bjo-2024-326221","DOIUrl":"https://doi.org/10.1136/bjo-2024-326221","url":null,"abstract":"Aims To report main outcomes and complications following voretigene neparvovec (Luxturna) treatment in paediatric patients. Methods Records of patients under the age of 17 treated by subretinal administration of voretigene neparvovec for confirmed biallelic RPE65 -mediated inherited retinal dystrophy were retrospectively reviewed. Best-corrected visual acuity (BCVA) and data from spectral-domain optical coherence tomography, ultra-wide-field fundus imaging and Goldmann visual field (VF) were analysed at 12 months follow-up. Results 12 eyes of six patients (mean age: 7.8 years) were analysed. No intraoperative complications occurred. BCVA significantly improved at 12-month follow-up (mean LogMAR (logarithm of the minimal angle of resolution) BCVA: 1.0±0.8 at baseline vs 0.6±0.3 at 12 months, p=0.001). Mean central macular thickness and central outer nuclear layer thickness did not change at 12 months follow-up. VF V4e isopter did not show significant changes. Postoperatively complications included: elevated intraocular pressure in two eyes of the same patient, a parafoveal lamellar hole at 3 months post-treatment and atrophy on the injection site observed in all eyes except one, which significantly enlarged during 12 months (p=0.008). Conclusions Most paediatric patients treated by voretigene neparvovec showed a significant increase in visual function at 12 months follow-up. None of the postoperative complications prevented gains in visual function. All data relevant to the study are included in the article or uploaded as supplementary information. NA.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"60 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684534","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}
引用次数: 0
Clinical characteristics and optical coherence tomography features of ocular toxoplasmosis inHIV-positive patients: report 1 HIV 阳性患者眼弓形虫病的临床特征和光学相干断层扫描特征:报告 1
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-20 DOI: 10.1136/bjo-2024-326306
Anamika Patel, Merlin Saldanha, Anup Kelagaonkar, Thorani Yediballi, Ilaria Testi, Carlos Pavesio, Avinash Pathengay
Purpose This study aimed to identify the various clinical characteristics and ocular imaging features of ocular toxoplasmosis (OT) in HIV patients. Methods Observational retrospective study of 52 eyes of 38 HIV patients with OT. Results 68% of patients were male. 53.8% of eyes had keratic precipitates, anterior chamber cells were seen in 61.5%. 57.69% (n=30) eyes had de novo presentation of retinitis and 42.3% (n=22) of eyes had a retinochoroidal scar at presentation. Bilateral presentation was seen in 37% (n=14). Unifocal retinitis was noted in 38.4% (n=20) and 61.5% of eyes had multifocal (multizonal) retinitis (n=32). The most common multizonal involvement was noted in combined zone 1+2(n=14, 26.9%). The average horizontal and vertical measurements retinitis was 8.35 mm and 7.48 mm, respectively. The average area of retinitis was 66.2 mm2. Localised posterior vitreous detachment was seen in 83% of eyes and posterior hyaloid precipitates were noted in (n=7,39%) of eyes. Retinitis without retinal pigment epithelium elevation occurred in 88.8% of cases, compared with retinitis with retinal pigment epithelium elevation seen in 44.4% of eyes. 50% of eyes had thickened choroid beneath the retinitis lesion. Other unique signs of optical coherence tomography (OCT) noted were angular signs of Henle fibre layer hyper-reflectivity sign (n=1), halo lesions with central hypo (n=3) and choroidal excavation (n=1). Conclusions OT in HIV patients presents with large, bilateral, multifocal retinitis, generally devoid of haemorrhages and can rarely have central clearing. These lesions may present with or without a previous retinochoroidal scar. These lesions have horizontal spread and may not always have thickened choroid on OCT. Data are available on reasonable request.
目的 本研究旨在确定 HIV 患者眼弓形虫病(OT)的各种临床特征和眼部影像学特征。方法 对 38 名 OT 患者的 52 只眼睛进行观察性回顾研究。结果 68%的患者为男性。53.8%的眼球有角膜沉淀,61.5%的眼球可见前房细胞。57.69%(30 眼)的患者为新发视网膜炎,42.3%(22 眼)的患者在发病时有视网膜脉络膜瘢痕。双侧发病者占 37%(14 只)。38.4%的眼睛(20 只)患有单灶视网膜炎,61.5%的眼睛(32 只)患有多灶(多区)视网膜炎。最常见的多区受累是1+2区联合受累(14只,26.9%)。视网膜炎的平均水平和垂直测量值分别为 8.35 毫米和 7.48 毫米。视网膜炎的平均面积为 66.2 平方毫米。83%的眼睛出现局部玻璃体后脱离,7,39%的眼睛出现玻璃体后沉淀。88.8%的病例出现视网膜炎,但无视网膜色素上皮细胞增生;44.4%的病例出现视网膜炎,但有视网膜色素上皮细胞增生。50%的眼睛在视网膜炎病变下方有增厚的脉络膜。光学相干断层扫描(OCT)发现的其他独特征象包括:Henle纤维层高反射角征(n=1)、中心低的光晕病变(n=3)和脉络膜挖空(n=1)。结论 HIV 患者的 OT 表现为大面积、双侧、多灶性视网膜炎,一般无出血,很少有中心清亮。这些病变可能伴有或不伴有先前的视网膜脉络膜瘢痕。这些病变呈水平扩散,在 OCT 上不一定会有增厚的脉络膜。如有合理要求,可提供相关数据。
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引用次数: 0
Comparison of baseline clinical characteristics and patterns of visual field defects between high-tension and normal-tension glaucoma 高眼压性青光眼和正常眼压性青光眼的基线临床特征和视野缺损模式比较
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-19 DOI: 10.1136/bjo-2023-324852
Zidong Chen, Wenxin Yang, Yangfan Yang, Yuzhen Jiang, Yuning Zhang, Xinyi Zhang, Chongxuan Luo, Mingqin Wang, Yanmei Fan, Pingping Liu, Neil Nathwani, Gus Gazzard, Minbin Yu
Aims To compare the baseline clinical characteristics and patterns of visual field defects between high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) in the Laser in Glaucoma and Ocular Hypertension (LiGHT) China subjects. Methods All patients (n=622) were recruited at Zhongshan Ophthalmic Center from 2015 to 2019. 1105 open-angle glaucoma eyes of 622 patients were classified as NTG (n=559) and HTG eyes (n=546) according to the baseline intraocular pressure (IOP) of 21 mm Hg. The mean deviation (MD), regional MD of the Glaucoma Hemifield Test regions and regional difference values were calculated. Daytime phasing IOP was recorded at 8:00, 10:00, 11:30, 14:30 and 17:00 hour. Multiple regression analyses were conducted for each regional difference. Results Patients with NTG were older, more likely to be female, hypertensive and suffer ischaemic heart disease than patients with HTG (p<0.05 for all comparisons). HTG showed higher mean daytime phasing IOP and higher daytime fluctuations than NTG (p<0.001 for all comparisons). HTG and NTG showed similar MD overall (p=0.665). NTG showed significantly greater hemifield asymmetry than HTG. The two arcuate regional differences in NTG were significantly associated with daytime IOP fluctuations (p<0.01 in both regions). Conclusions In the LiGHT China trial, NTG and HTG showed similar visual field defects severity at enrolment. However, NTG showed more severe hemifield asymmetry compared with HTG, and higher short-time IOP fluctuations might exacerbate this asymmetry in NTG. Data are available upon reasonable request.
目的 比较高眼压性青光眼(HTG)和正常眼压性青光眼(NTG)的基线临床特征和视野缺损模式。方法 所有患者(n=622)均于2015年至2019年在中山眼科中心招募。根据基线眼压(IOP)21 mm Hg,将622名患者中的1105只开角型青光眼眼分为NTG眼(n=559)和HTG眼(n=546)。计算青光眼半视野测试区域的平均偏差(MD)、区域 MD 和区域差异值。在 8:00、10:00、11:30、14:30 和 17:00 时记录日间阶段性眼压。对每个区域差异进行多元回归分析。结果 与 HTG 患者相比,NTG 患者年龄更大,更可能是女性、高血压和缺血性心脏病患者(所有比较中,P<0.05)。与 NTG 相比,HTG 患者的日间阶段性平均眼压更高,日间波动也更大(所有比较中,P<0.001)。HTG 和 NTG 的 MD 总体相似(p=0.665)。与 HTG 相比,NTG 的半球不对称程度明显更高。NTG 的两个弧形区域差异与日间眼压波动显著相关(两个区域的 p 均<0.01)。结论 在 LiGHT 中国试验中,NTG 和 HTG 在入组时表现出相似的视野缺损严重程度。然而,与 HTG 相比,NTG 表现出更严重的半视野不对称,更高的短时眼压波动可能会加剧 NTG 的这种不对称。如有合理要求,可提供相关数据。
{"title":"Comparison of baseline clinical characteristics and patterns of visual field defects between high-tension and normal-tension glaucoma","authors":"Zidong Chen, Wenxin Yang, Yangfan Yang, Yuzhen Jiang, Yuning Zhang, Xinyi Zhang, Chongxuan Luo, Mingqin Wang, Yanmei Fan, Pingping Liu, Neil Nathwani, Gus Gazzard, Minbin Yu","doi":"10.1136/bjo-2023-324852","DOIUrl":"https://doi.org/10.1136/bjo-2023-324852","url":null,"abstract":"Aims To compare the baseline clinical characteristics and patterns of visual field defects between high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) in the Laser in Glaucoma and Ocular Hypertension (LiGHT) China subjects. Methods All patients (n=622) were recruited at Zhongshan Ophthalmic Center from 2015 to 2019. 1105 open-angle glaucoma eyes of 622 patients were classified as NTG (n=559) and HTG eyes (n=546) according to the baseline intraocular pressure (IOP) of 21 mm Hg. The mean deviation (MD), regional MD of the Glaucoma Hemifield Test regions and regional difference values were calculated. Daytime phasing IOP was recorded at 8:00, 10:00, 11:30, 14:30 and 17:00 hour. Multiple regression analyses were conducted for each regional difference. Results Patients with NTG were older, more likely to be female, hypertensive and suffer ischaemic heart disease than patients with HTG (p<0.05 for all comparisons). HTG showed higher mean daytime phasing IOP and higher daytime fluctuations than NTG (p<0.001 for all comparisons). HTG and NTG showed similar MD overall (p=0.665). NTG showed significantly greater hemifield asymmetry than HTG. The two arcuate regional differences in NTG were significantly associated with daytime IOP fluctuations (p<0.01 in both regions). Conclusions In the LiGHT China trial, NTG and HTG showed similar visual field defects severity at enrolment. However, NTG showed more severe hemifield asymmetry compared with HTG, and higher short-time IOP fluctuations might exacerbate this asymmetry in NTG. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"128 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142673241","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}
引用次数: 0
Refractive changes in children in the Chicago area during the COVID-19 pandemic: a retrospective observational study. COVID-19 大流行期间芝加哥地区儿童的屈光变化:一项回顾性观察研究。
IF 3.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-18 DOI: 10.1136/bjo-2024-325984
Eugene Kim, Magdalena Stec, Noreen Shaikh, Jonathan Huang, Hantamalala Ralay Ranaivo, Rebecca Mets-Halgrimson

Background: Remote learning during the COVID-19 pandemic caused behavioural changes such as increased screen time and decreased outdoor time. This study aimed to investigate myopia progression in children during the COVID-19 pandemic.

Methods: This was a retrospective observational study performed among 2064 patients ages 2-17 with cycloplegic refractions in the months of January 2019-March 2021 at a tertiary children's hospital. Exclusion criteria were a medical history of relevant connective tissue diseases, myopia control treatment, pseudophakia and aphakia.

Results: The overall cohort (n=2064) had a mean spherical equivalent (SE) of 0.12±3.70 D in 2019, -0.07±3.95 D in 2020 and -0.49±3.85 D in 2021. The change in mean SE (0.42 D) from 2020 to 2021 was 2.2 times greater than the change (0.19 D) from 2019 to 2020 at baseline. In the cohort of return patients, there was a significant difference in myopic shift between years (F-ratio=14.4, p<0.00001), and a significant change from 2020 to 2021 (p=0.00008) but not from 2019 to 2020. When observing the prevalence of myopia grouped by age, 8-year-old and 17-year-old patients had the greatest increase compared with baseline. When grouped by refractive error, low myopia children (-0.5 D to -3.00 D) displayed the greatest change in mean SE 2020-2021.

Conclusions: There was a substantial increase in myopia progression for children in the Chicagoland area after the period of COVID-19 changes. The behavioural changes of home confinement and online learning during the pandemic may explain these findings.

背景:COVID-19 大流行期间的远程学习引起了行为变化,如屏幕时间增加和户外活动时间减少。本研究旨在调查 COVID-19 大流行期间儿童近视的发展情况:这是一项回顾性观察研究,研究对象为一家三级儿童医院在 2019 年 1 月至 2021 年 3 月期间接受环镜屈光检查的 2064 名 2-17 岁患者。排除标准为有相关结缔组织疾病病史、近视控制治疗、假性近视和无晶体眼:总体队列(n=2064)在2019年的平均球面等效(SE)为0.12±3.70 D,2020年为-0.07±3.95 D,2021年为-0.49±3.85 D。从2020年到2021年,平均SE的变化(0.42 D)是基线值从2019年到2020年变化(0.19 D)的2.2倍。在回国患者队列中,不同年份之间的近视度数变化存在显著差异(F-ratio=14.4,pConclusions:在 COVID-19 变化期之后,芝加哥地区儿童的近视度数大幅增加。大流行期间的家庭限制和在线学习等行为变化可能解释了这些发现。
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引用次数: 0
Outlier ophthalmologists in the treatment of neovascular age-related macular degeneration with intravitreal therapy. 使用玻璃体内疗法治疗新生血管性老年黄斑变性的离群眼科医生。
IF 3.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2024-11-14 DOI: 10.1136/bjo-2024-326024
Yohei Hashimoto, Adrian Robert Hunt, Jane M Wells, Gayatri Banerjee, Ross Ferrier, Richard Barry, Andrew Field, Justin Game, Claire Yvonne Hooper, Daniel Barthelmes, Mark C Gillies

Background: To compare individual ophthalmologists grouped as outliers or non-outliers based on the mean 12-month visual acuity (VA) outcomes for their patients with neovascular age-related macular degeneration (nAMD).

Methods: This prospectively designed database study included treatment-naïve eyes with nAMD starting vascular endothelial growth factor inhibitors between July 2018 and April 2023 in Australia. Ophthalmologists were classified into high outliers, non-outliers and low outliers with a funnel plot of the adjusted mean 12-month VA change. The number of injections, last injection interval and proportion of visits where choroidal neovascularisation was active were compared between the groups.

Results: 38 ophthalmologists who treated a total of 1266 eyes (male, 35%; mean age, 81 years old) were classified into 1 high outlier, 34 non-outliers and 3 low outliers (mean VA change, 7.5, 5.1 and 2.5 letters, respectively). The high outlier gave significantly more injections than the non-outliers (mean, 8.6 vs 7.7; p<0.001), while the low outliers administered significantly fewer injections than the non-outliers (mean, 7.1 vs 7.7; p=0.009). The last injection interval was shortest in the high outlier's eyes (9.4 weeks), followed by non-outliers' (10.8 weeks; p=0.04 (vs high outlier's)) and low outliers' (11.8 weeks; p=0.22 (vs non-outliers')). The low outliers' patients had more visits with intraretinal fluid (59%) than non-outliers' (29%; p<0.001) and high outlier's patients (31%; p<0.001).

Conclusion: The low outliers' eyes had fewer injections, a longer treatment interval and more visits with intraretinal fluid. Building a system through which low outliers are anonymously notified of their performance would help improve general quality of care.

背景:比较根据新生血管性年龄相关性黄斑变性(nAMD)患者12个月平均视力(VA)结果将个体眼科医生归为离群值或非离群值的情况:这项前瞻性设计的数据库研究纳入了澳大利亚在2018年7月至2023年4月期间开始使用血管内皮生长因子抑制剂的nAMD患者。根据调整后的 12 个月平均 VA 变化的漏斗图,将眼科医生分为高离群值、非离群值和低离群值。比较了各组的注射次数、最后一次注射间隔和脉络膜新生血管活跃的就诊比例:38名眼科医生共治疗了1266只眼睛(男性,35%;平均年龄81岁),并将其分为1个高度离群组、34个非离群组和3个低度离群组(平均视力变化分别为7.5、5.1和2.5个字母)。高度离群者的注射次数明显多于非离群者(平均为 8.6 次对 7.7 次;p 结论:低度离群者的眼睛视力变化较小:低离群者的眼睛注射次数较少,治疗间隔时间较长,视网膜内积液就诊次数较多。建立一个系统,通过该系统匿名通报低异常值者的表现,将有助于提高总体护理质量。
{"title":"Outlier ophthalmologists in the treatment of neovascular age-related macular degeneration with intravitreal therapy.","authors":"Yohei Hashimoto, Adrian Robert Hunt, Jane M Wells, Gayatri Banerjee, Ross Ferrier, Richard Barry, Andrew Field, Justin Game, Claire Yvonne Hooper, Daniel Barthelmes, Mark C Gillies","doi":"10.1136/bjo-2024-326024","DOIUrl":"https://doi.org/10.1136/bjo-2024-326024","url":null,"abstract":"<p><strong>Background: </strong>To compare individual ophthalmologists grouped as outliers or non-outliers based on the mean 12-month visual acuity (VA) outcomes for their patients with neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>This prospectively designed database study included treatment-naïve eyes with nAMD starting vascular endothelial growth factor inhibitors between July 2018 and April 2023 in Australia. Ophthalmologists were classified into high outliers, non-outliers and low outliers with a funnel plot of the adjusted mean 12-month VA change. The number of injections, last injection interval and proportion of visits where choroidal neovascularisation was active were compared between the groups.</p><p><strong>Results: </strong>38 ophthalmologists who treated a total of 1266 eyes (male, 35%; mean age, 81 years old) were classified into 1 high outlier, 34 non-outliers and 3 low outliers (mean VA change, 7.5, 5.1 and 2.5 letters, respectively). The high outlier gave significantly more injections than the non-outliers (mean, 8.6 vs 7.7; p<0.001), while the low outliers administered significantly fewer injections than the non-outliers (mean, 7.1 vs 7.7; p=0.009). The last injection interval was shortest in the high outlier's eyes (9.4 weeks), followed by non-outliers' (10.8 weeks; p=0.04 (vs high outlier's)) and low outliers' (11.8 weeks; p=0.22 (vs non-outliers')). The low outliers' patients had more visits with intraretinal fluid (59%) than non-outliers' (29%; p<0.001) and high outlier's patients (31%; p<0.001).</p><p><strong>Conclusion: </strong>The low outliers' eyes had fewer injections, a longer treatment interval and more visits with intraretinal fluid. Building a system through which low outliers are anonymously notified of their performance would help improve general quality of care.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615185","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}
引用次数: 0
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British Journal of Ophthalmology
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