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Effects of nicotinamide supplementation in normal-tension glaucoma: a crossover placebo-controlled randomised clinical trial. 补充烟酰胺对正常张力青光眼的影响:一项交叉安慰剂对照随机临床试验。
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-30 DOI: 10.1136/bjo-2025-328096
Ahnul Ha,Young Kook Kim,Chang Kyu Lee,Pete A Williams,James E Morgan,Young In Shin,Eunsol Kim,Myungjin Kim,Seungsoo Rho
BACKGROUND/AIMSThe neuroprotective effect of nicotinamide (NAM) supplementation has been demonstrated in both animal models and clinical trials. We conducted a trial to assess whether oral NAM improves retinal function in normal-tension glaucoma (NTG) participants receiving intraocular pressure (IOP)-lowering therapy.METHODSFifty-three NTG participants (untreated IOP ≤18 mm Hg) were enrolled in a double-masked, placebo-controlled crossover randomised clinical trial. Participants were randomly assigned to receive either oral placebo or NAM, followed by crossover without a washout period. Each treatment was administered for 12 weeks (NAM/placebo 1 g/day for 6 weeks, then 2 g/day for the subsequent 6 weeks). Retinal function was evaluated using full-field electroretinography and visual field testing.RESULTSAfter 12 weeks, the amplitude changes of the photopic negative response in peak-to-trough (PhNRPT) and the B-wave were significantly greater in the NAM group (3.121±3.968 and 2.112±3.220 μV, respectively) compared with the placebo group (0.996±4.190 and 0.305±3.279 μV, respectively; p=0.045 and p=0.032). PhNRPT improved beyond twice the 95% coefficient of variation in 29.0% of the NAM group and 19.3% of the placebo group. No significant intergroup differences were observed in changes in mean deviation, pattern SD or visual field index after 12 weeks.CONCLUSIONOral NAM supplementation in NTG participants induced functional improvement, as measured by PhNRPT and B-wave amplitude. Given that NTG is characterised by lower IOP, which may show a weaker correlation with electrophysiological activity and a slower progression rate compared with high-tension glaucoma, further long-term studies are needed to clarify the effects of NAM in this population.TRIAL REGISTRATION NUMBERNCT06078605.
背景/目的补充烟酰胺(NAM)的神经保护作用已在动物模型和临床试验中得到证实。我们进行了一项试验,以评估口服NAM是否能改善接受降低眼压治疗的正常眼压青光眼(NTG)患者的视网膜功能。方法53例NTG患者(未治疗IOP≤18 mm Hg)纳入双盲、安慰剂对照交叉随机临床试验。参与者被随机分配接受口服安慰剂或NAM,随后进行无洗脱期的交叉试验。每次治疗持续12周(NAM/安慰剂1 g/天,连续6周,然后2 g/天,连续6周)。采用全视野视网膜电图和视野测试评估视网膜功能。结果12周后,NAM组的峰谷光负反应(PhNRPT)和b波振幅变化(分别为3.121±3.968和2.112±3.220 μV)显著高于安慰剂组(分别为0.996±4.190和0.305±3.279 μV, p=0.045和p=0.032)。PhNRPT改善了29.0%的NAM组和19.3%的安慰剂组95%变异系数的两倍以上。12周后各组平均偏差、模式SD、视野指数变化无显著差异。结论:通过PhNRPT和b波振幅测量,口服NAM补充剂可促进NTG参与者的功能改善。鉴于NTG的特点是较低的IOP,与高张力性青光眼相比,其与电生理活动的相关性较弱,进展速度较慢,因此需要进一步的长期研究来阐明NAM对这一人群的影响。试验注册号:06078605。
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引用次数: 0
Ethnic and dose-dependent differences in atropine efficacy for myopia control: a systematic review and meta-analysis. 阿托品控制近视疗效的种族和剂量依赖性差异:系统回顾和荟萃分析。
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-30 DOI: 10.1136/bjo-2025-328518
Sayantan Biswas,Carla Lanca,Daisy Kynman-Sprinks,Andrzej Grzybowski
BACKGROUND/AIMClinical uncertainty remains regarding optimal atropine concentration, treatment duration and potential differences in efficacy for myopia control between Asian and non-Asian children. This systematic review and meta-analysis evaluated the efficacy of different concentrations of atropine for myopia control, comparing outcomes among East Asian, South Asian and white European children.METHODSFive databases were searched for randomised controlled trials (RCTs) including children ≤16 years with myopia who received atropine treatment. 34 RCTs with ≥12 months of follow-up were included. Weighted mean differences (WMD) in spherical equivalent refraction (SER) progression and axial length (AL) elongation were pooled by atropine concentration and ethnicity.RESULTSCompared with controls, atropine significantly reduced myopia progression across all concentrations: <0.1% (WMD in SER: 0.44 (95% CI 0.35 to 0.52) dioptres (D)/year; AL: -0.20 (95% CI -0.24 to -0.16) mm/year), 0.1% to <0.5% (0.81 (95% CI 0.50 to 1.13) D/year) and ≥0.5% (1.06 (95% CI 0.88 to 1.24) D/year; -0.36 (95% CI -0.40 to -0.33) mm/year). The pooled effect on SER and AL progression across all concentrations was greater in East Asians (0.63 (95% CI 0.50 to 0.76) D/year; -0.26 (95% CI -0.31 to -0.20) mm/year) than in South Asians (0.40 (95% CI 0.11 to 0.70) D/year; -0.13 (95% CI -0.21 to -0.05) mm/year) or white Europeans (0.18 (95% CI 0.11 to 0.25) D/year; -0.11 (95% CI -0.16 to -0.05) mm/year).CONCLUSIONAtropine slows myopia progression in a dose-dependent manner in studies with 1-5 years. Efficacy appears greater in Asian children, particularly East Asians, who also exhibit greater photopic pupil dilation. These findings support the role of atropine in myopia control and highlight the importance of ethnicity-specific considerations when prescribing and tailoring treatment strategies.PROSPERO REGISTRATION NUMBERCRD42023454104.
亚洲和非亚洲儿童控制近视的最佳阿托品浓度、治疗时间和潜在疗效差异仍存在临床不确定性。本系统综述和荟萃分析评估了不同浓度阿托品控制近视的疗效,比较了东亚、南亚和欧洲白人儿童的结果。方法检索5个数据库,纳入≤16岁近视儿童接受阿托品治疗的随机对照试验(rct)。纳入随访≥12个月的34项rct。球等效折射(SER)进展和轴向长度(AL)延伸的加权平均差异(WMD)根据阿托品浓度和种族进行汇总。结果与对照组相比,阿托品在所有浓度下均显著降低了近视进展:<0.1% (SER WMD: 0.44 (95% CI 0.35 ~ 0.52)屈光度(D)/年;AL: -0.20 (95% CI -0.24至-0.16)mm/年),0.1%至<0.5% (0.81 (95% CI 0.50至1.13)D/年)和≥0.5% (1.06 (95% CI 0.88至1.24)D/年;-0.36 (95% CI -0.40至-0.33)mm/年)。所有浓度对SER和AL进展的综合影响在东亚地区更大(0.63 (95% CI 0.50至0.76)D/年;-0.26 (95% CI -0.31至-0.20)mm/年)比南亚(0.40 (95% CI 0.11至0.70)D/年;-0.13 (95% CI -0.21至-0.05)mm/年)或白种欧洲人(0.18 (95% CI 0.11至0.25)D/年;-0.11 (95% CI -0.16至-0.05)mm/年)。结论在1-5年的研究中,阿托品以剂量依赖的方式减缓近视进展。亚洲儿童,特别是东亚儿童的效果更好,他们也表现出更大的光性瞳孔扩张。这些发现支持阿托品在近视控制中的作用,并强调在处方和定制治疗策略时考虑种族特异性的重要性。普洛斯彼罗注册号crd42023454104。
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引用次数: 0
Incidental ocular surface squamous neoplasia in pterygia: a systematic review and meta-analysis. 翼状胬肉中偶发的眼表鳞状瘤变:一项系统回顾和荟萃分析。
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-30 DOI: 10.1136/bjo-2025-328299
Andrew Mihalache,Ryan S Huang,Michael Balas,Benjamin Bert,Roxana Y Godiwalla Do,Hugo Hsu,Marko Popovic,Clara C Chan
AIMSDifferentiating pterygium from ocular surface squamous neoplasia (OSSN) is important for guiding management. This meta-analysis evaluates the prevalence and risk factors for incidental OSSN in clinically diagnosed pterygia.METHODSOvid Embase, MEDLINE, Cochrane Library and Web of Science were systematically searched from January 2000 to February 2025. Included studies analysed ≥100 clinically diagnosed pterygia via histopathology. Random-effects meta-analysis assessed the prevalence of incidental OSSN among pterygia. Risk factors were evaluated using the Mantel-Haenszel and inverse variance methods, and meta-regression analysed the influence of publication year, geographic proximity to the equator, and country-level ultraviolet (UV) radiation exposure.RESULTS12 studies, comprising 8688 specimens, identified 202 cases of incidental OSSN (pooled prevalence=1.32%, 95% CI 0.41% to 4.21%, I2=95.3%). Meta-regression revealed that lower OSSN prevalence was associated with greater distance from the equator (OR 0.49, 95% CI 0.28 to 0.83, p<0.01), while higher prevalence was associated with greater UV exposure (OR 2.20, 95% CI 1.17 to 4.14, p=0.01). Publication year had no effect (p=0.98). Age (p=0.18), sex (p=0.45) and lesion location (p=0.60-0.82) did not differ between incidental OSSN cases and benign pterygia. Incidental OSSN prevalence also did not differ between primary and recurrent pterygia (p=0.23). Regional analyses revealed variation in prevalence: Europe (0.29%), Asia (0.76%), North America (1.03%), Oceania (8.57%) and South America (14.97%).CONCLUSIONSThis meta-analysis, based on low- to very low-certainty evidence, identified a 1.32% pooled prevalence of incidental OSSN in clinically diagnosed pterygia, highlighting the potential influence of UV exposure and equatorial proximity. The overlap in demographic and lesion characteristics between benign pterygia and OSSN underscores diagnostic challenges.
目的:鉴别翼状胬肉与眼表鳞状瘤变(OSSN)对指导治疗具有重要意义。本荟萃分析评估了临床诊断的翼状胬肉中偶发OSSN的患病率和危险因素。方法系统检索2000年1月~ 2025年2月的数据库Embase、MEDLINE、Cochrane Library和Web of Science。纳入的研究通过组织病理学分析了≥100例临床诊断的翼状胬肉。随机效应荟萃分析评估了翼状胬肉中偶发OSSN的发生率。使用Mantel-Haenszel和反方差方法评估危险因素,并进行meta回归分析出版年份、地理位置接近赤道和国家水平紫外线照射的影响。结果12项研究共8688例样本,发现202例偶发性OSSN(合并患病率1.32%,95% CI 0.41% ~ 4.21%, I2=95.3%)。meta回归显示,较低的OSSN患病率与距离赤道较远相关(OR 0.49, 95% CI 0.28 ~ 0.83, p<0.01),而较高的患病率与较多的紫外线暴露相关(OR 2.20, 95% CI 1.17 ~ 4.14, p=0.01)。出版年份无影响(p=0.98)。年龄(p=0.18)、性别(p=0.45)和病变部位(p=0.60-0.82)在偶发性OSSN和良性翼状胬肉之间没有差异。原发性和复发性翼状胬肉的OSSN发生率也无差异(p=0.23)。区域分析显示患病率存在差异:欧洲(0.29%)、亚洲(0.76%)、北美(1.03%)、大洋洲(8.57%)和南美(14.97%)。结论:本荟萃分析基于低至极低确定性的证据,确定临床诊断的翼状胬肉中偶发OSSN的总患病率为1.32%,突出了紫外线暴露和赤道邻近的潜在影响。良性翼状胬肉和OSSN在人口学和病变特征上的重叠强调了诊断上的挑战。
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引用次数: 0
Choroidal changes correlate with type 1 neovascular activity in neovascular age-related macular degeneration and polypoidal choroidal vasculopathy. 脉络膜变化与新生血管性年龄相关性黄斑变性和息肉样脉络膜血管病变的1型新生血管活动相关。
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-30 DOI: 10.1136/bjo-2025-327839
Xiaoxu Huang,Jieqiong Chen,Jianqing Li,Guanran Zhang,Xinyue Zhu,Minwen Zhou,Qiyu Bo,Xiaodong Sun
PURPOSETo investigate the association among choroidal factors and lesion activity of polypoidal choroidal vasculopathy (PCV) and type I neovascular age-related macular degeneration (nAMD) using swept-source optical coherence tomography angiography (SS-OCTA).METHODS69 eyes with PCV or type I nAMD were retrospectively included. All eyes had either ≥2 consecutive non-exudative visits without treatment or no exudation/treatment within 6-month SS-OCTA follow-up. Lesions were categorised into active and inactive based on progression, defined as exudation, branching vascular network (BVN)/macular neovascularisation enlargement or recurrence/new/growth of polypoidal lesions. Choroidal parameters, including mean choroidal thickness (MCT), choroidal vascularity index (CVI) and choroidal volume (CV), were evaluated before and after lesion progression. The association between CVI variation and lesion area growth in PCV was also analysed.RESULTSNo baseline differences in MCT or CVI were found between PCV and nAMD. However, significant differences in CVI and MCT variation were observed between active and inactive lesions (p<0.05). In PCV, lesion activity was characterised by decreased CVI and increased MCT, while in nAMD, only MCT and CV increased. Notably, combined CVI decrease and MCT increase served as a sensitive marker for active PCV (p<0.05), but not for nAMD. CVI reduction also correlated with BVN growth in PCV (R=-0.722, p<0.01).CONCLUSIONChoroidal parameters varied significantly during lesion progression. Combined CVI decrease and MCT increase sensitively reflected active PCV lesions and were correlated with lesion location, size and progression, highlighting the differences in the choroidal microenvironment in the activities of PCV and nAMD.
目的应用扫描源光学相干断层扫描血管造影(SS-OCTA)探讨脉络膜因子与息肉样脉络膜血管病变(PCV)和I型新生血管性年龄相关性黄斑变性(nAMD)病变活动性的关系。方法回顾性分析PCV或I型nAMD的69只眼。所有眼睛在没有治疗的情况下进行≥2次连续无渗出或在6个月的SS-OCTA随访期间无渗出/治疗。病变根据进展分为活动性和非活动性,定义为渗出、分支血管网络(BVN)/黄斑新生血管扩大或复发/新发/息肉样病变生长。在病变进展前后评估脉络膜参数,包括平均脉络膜厚度(MCT)、脉络膜血管指数(CVI)和脉络膜体积(CV)。还分析了CVI变异与PCV病变面积增长之间的关系。结果PCV和nAMD在MCT和CVI方面没有基线差异。然而,活动性病变与非活动性病变的CVI和MCT差异有统计学意义(p<0.05)。在PCV中,病变活动的特征是CVI降低和MCT升高,而在nAMD中,只有MCT和CV升高。值得注意的是,CVI降低和MCT升高是活性PCV的敏感标志物(p<0.05),而不是nAMD的敏感标志物。CVI降低也与PCV BVN生长相关(R=-0.722, p<0.01)。结论病变进展过程中脉络膜参数变化明显。CVI的降低和MCT的升高能敏感地反映PCV病变的活动性,并与病变的位置、大小和进展相关,突出了PCV和nAMD活性在脉络膜微环境中的差异。
{"title":"Choroidal changes correlate with type 1 neovascular activity in neovascular age-related macular degeneration and polypoidal choroidal vasculopathy.","authors":"Xiaoxu Huang,Jieqiong Chen,Jianqing Li,Guanran Zhang,Xinyue Zhu,Minwen Zhou,Qiyu Bo,Xiaodong Sun","doi":"10.1136/bjo-2025-327839","DOIUrl":"https://doi.org/10.1136/bjo-2025-327839","url":null,"abstract":"PURPOSETo investigate the association among choroidal factors and lesion activity of polypoidal choroidal vasculopathy (PCV) and type I neovascular age-related macular degeneration (nAMD) using swept-source optical coherence tomography angiography (SS-OCTA).METHODS69 eyes with PCV or type I nAMD were retrospectively included. All eyes had either ≥2 consecutive non-exudative visits without treatment or no exudation/treatment within 6-month SS-OCTA follow-up. Lesions were categorised into active and inactive based on progression, defined as exudation, branching vascular network (BVN)/macular neovascularisation enlargement or recurrence/new/growth of polypoidal lesions. Choroidal parameters, including mean choroidal thickness (MCT), choroidal vascularity index (CVI) and choroidal volume (CV), were evaluated before and after lesion progression. The association between CVI variation and lesion area growth in PCV was also analysed.RESULTSNo baseline differences in MCT or CVI were found between PCV and nAMD. However, significant differences in CVI and MCT variation were observed between active and inactive lesions (p<0.05). In PCV, lesion activity was characterised by decreased CVI and increased MCT, while in nAMD, only MCT and CV increased. Notably, combined CVI decrease and MCT increase served as a sensitive marker for active PCV (p<0.05), but not for nAMD. CVI reduction also correlated with BVN growth in PCV (R=-0.722, p<0.01).CONCLUSIONChoroidal parameters varied significantly during lesion progression. Combined CVI decrease and MCT increase sensitively reflected active PCV lesions and were correlated with lesion location, size and progression, highlighting the differences in the choroidal microenvironment in the activities of PCV and nAMD.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"16 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403773","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
Genetic associations of high myopia 高度近视的遗传关联
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-28 DOI: 10.1136/bjo-2025-327791
Bin Mao, Xing-Xuan Dong, Shi-Yi Gong, Dan-Lin Li, Qiao Fan, Chen-Wei Pan
Aims The impact of genetic variants on high myopia (HM) remains unclear. This study aims to systematically evaluate the relationship between genetic polymorphisms and HM. Methods Eligible studies were retrieved from five databases (PubMed, Web of Science, Cochrane, Embase and Scopus) up to 18 January 2025. We included all case-control studies that examined the association of single nucleotide polymorphisms (SNPs) with HM susceptibility. Fixed or random effects models were used to evaluate pooled ORs and CIs for each SNP in HM. Sensitivity analyses were conducted to assess the reliability and stability of the results. Results Seventy-six studies (89 separate cohorts) were eligible for the meta-analysis of HM, involving 77 SNPs in 34 genes. Twenty-two SNPs in 13 genes (rs1516794 in ACAN gene; rs2269336 in COL1A1 gene; rs2071861 and rs2009066 in CRYBA4 gene; rs339501 in FGF10 gene; rs698047 in HIVEP3 gene; rs3741834, rs2300588, rs3759223 and rs7135740 in LUM gene; rs9318086 in MIPEP gene; rs243845 and rs1861320 in MMP2 gene; rs662702 and rs644242 in PAX6 gene; rs8027411 and rs17175798 in RASGRF1 gene; rs7839488, rs4395927 and rs6469937 in SNTB1 gene; rs1800470 in TGFβ1 gene; and rs7829127 in ZMAT4 gene) showed significant associations with HM. Conclusion This study identified 22 SNPs in 13 genes ( ACAN , COL1A1 , CRYBA4 , FGF10 , HIVEP3 , LUM , MIPEP , MMP2 , PAX6 , RASGRF1 , SNTB1 , TGFβ1 and ZMAT4 ) as potential genetic biomarkers for HM. Future research should conduct large-scale genome-wide association studies across diverse populations to yield more robust evidence. No data are available.
目的遗传变异对高度近视(HM)的影响尚不清楚。本研究旨在系统评价遗传多态性与HM的关系。方法从截至2025年1月18日的5个数据库(PubMed、Web of Science、Cochrane、Embase和Scopus)中检索符合条件的研究。我们纳入了所有检测单核苷酸多态性(snp)与HM易感性关系的病例对照研究。固定或随机效应模型用于评估HM中每个SNP的合并or和ci。进行敏感性分析以评估结果的可靠性和稳定性。结果76项研究(89个独立队列)符合HM的荟萃分析,涉及34个基因的77个snp。13个基因中的22个snp (ACAN基因rs1516794、COL1A1基因rs2269336、CRYBA4基因rs2071861、rs2009066、FGF10基因rs339501、HIVEP3基因rs698047、LUM基因rs3741834、rs2300588、rs3759223、rs7135740、MIPEP基因rs9318086、MMP2基因rs243845、rs1861320、PAX6基因rs662702、rs644242、RASGRF1基因rs8027411、rs17175798、SNTB1基因rs7839488、rs4395927、rs6469937、TGFβ1基因rs1800470、rs17175798)。ZMAT4基因rs7829127)与HM有显著相关性。结论本研究发现13个基因(ACAN、COL1A1、CRYBA4、FGF10、HIVEP3、LUM、MIPEP、MMP2、PAX6、RASGRF1、SNTB1、TGFβ1和ZMAT4)中的22个snp可能是HM的潜在遗传生物标志物。未来的研究应该在不同的人群中进行大规模的全基因组关联研究,以获得更有力的证据。无数据。
{"title":"Genetic associations of high myopia","authors":"Bin Mao, Xing-Xuan Dong, Shi-Yi Gong, Dan-Lin Li, Qiao Fan, Chen-Wei Pan","doi":"10.1136/bjo-2025-327791","DOIUrl":"https://doi.org/10.1136/bjo-2025-327791","url":null,"abstract":"Aims The impact of genetic variants on high myopia (HM) remains unclear. This study aims to systematically evaluate the relationship between genetic polymorphisms and HM. Methods Eligible studies were retrieved from five databases (PubMed, Web of Science, Cochrane, Embase and Scopus) up to 18 January 2025. We included all case-control studies that examined the association of single nucleotide polymorphisms (SNPs) with HM susceptibility. Fixed or random effects models were used to evaluate pooled ORs and CIs for each SNP in HM. Sensitivity analyses were conducted to assess the reliability and stability of the results. Results Seventy-six studies (89 separate cohorts) were eligible for the meta-analysis of HM, involving 77 SNPs in 34 genes. Twenty-two SNPs in 13 genes (rs1516794 in ACAN gene; rs2269336 in COL1A1 gene; rs2071861 and rs2009066 in CRYBA4 gene; rs339501 in FGF10 gene; rs698047 in HIVEP3 gene; rs3741834, rs2300588, rs3759223 and rs7135740 in LUM gene; rs9318086 in MIPEP gene; rs243845 and rs1861320 in MMP2 gene; rs662702 and rs644242 in PAX6 gene; rs8027411 and rs17175798 in RASGRF1 gene; rs7839488, rs4395927 and rs6469937 in SNTB1 gene; rs1800470 in TGFβ1 gene; and rs7829127 in ZMAT4 gene) showed significant associations with HM. Conclusion This study identified 22 SNPs in 13 genes ( ACAN , COL1A1 , CRYBA4 , FGF10 , HIVEP3 , LUM , MIPEP , MMP2 , PAX6 , RASGRF1 , SNTB1 , TGFβ1 and ZMAT4 ) as potential genetic biomarkers for HM. Future research should conduct large-scale genome-wide association studies across diverse populations to yield more robust evidence. No data are available.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"3 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145381663","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
Lamellar hole-associated epiretinal proliferation: pathophysiology, clinical role and treatment strategies. 板层孔相关视网膜外膜增生:病理生理、临床作用及治疗策略。
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-28 DOI: 10.1136/bjo-2025-327876
Matteo Mario Carlà,Gianmarco Oreste,Mattia Cusato,Francesco Mottola,Giorgia Campaniello,Stanislao Rizzo
Lamellar hole-associated epiretinal proliferation (LHEP) is a distinctive clinical entity characterised by a homogeneous, medium-reflective material on optical coherence tomography that is commonly associated with lamellar macular holes (LMH). Since its initial description, significant advances have been made in understanding its histopathological origins, natural progression and clinical implications. Histological studies suggest LHEP likely originates from Müller cells, with immunohistochemical studies consistently demonstrating positivity for glial fibrillary acidic protein and glutamine synthetase. Unlike conventional epiretinal membranes, LHEP does not exhibit tractional properties and is often associated with deeper retinal defects and ellipsoid zone disruption. While early studies yielded conflicting results regarding the impact of LHEP on visual outcomes, recent evidence suggests that LMH with LHEP may represent a distinct clinical entity with potentially different management implications. Surgical approaches have evolved from conventional peeling techniques to LHEP-sparing and LHEP-embedding procedures, with recent innovations including autologous platelet-rich plasma therapy showing promising results. Emerging data suggest improved outcomes with these newer approaches, including the 'no-retina-touch' technique that minimises iatrogenic trauma while achieving high efficacy in foveal defect closure. This review synthesises the current understanding of LHEP, its clinical significance and evolving treatment strategies.
板层孔相关性视网膜前增殖(LHEP)是一种独特的临床实体,其特征是光学相干断层扫描上均匀的中等反射物质,通常与板层黄斑孔(LMH)有关。自其最初描述以来,在了解其组织病理学起源,自然进展和临床意义方面取得了重大进展。组织学研究表明,LHEP可能起源于 ller细胞,免疫组织化学研究一致显示胶质纤维酸性蛋白和谷氨酰胺合成酶阳性。与传统的视网膜前膜不同,LHEP不具有牵拉特性,通常与更深的视网膜缺陷和椭球区破坏有关。虽然早期的研究在LHEP对视力结果的影响方面得出了相互矛盾的结果,但最近的证据表明,LHEP合并LMH可能代表了一种独特的临床实体,具有潜在的不同管理意义。手术方法已经从传统的剥离技术发展到lhep保留和lhep嵌入程序,最近的创新包括自体富血小板血浆治疗显示出有希望的结果。新出现的数据表明,这些新方法改善了结果,包括“无视网膜接触”技术,该技术最大限度地减少了医源性创伤,同时在中央凹缺损闭合中取得了高效率。这篇综述综合了目前对LHEP的理解,其临床意义和不断发展的治疗策略。
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引用次数: 0
Structural MRI alterations in children with form-deprivation amblyopia: a propensity score-matched case-control study - a commentary. 形态剥夺性弱视儿童的结构MRI改变:一项倾向评分匹配的病例对照研究。
IF 4.1 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-24 DOI: 10.1136/bjo-2025-328321
Margaret M Reynolds,Susan M Culican,Jessica B Girault
{"title":"Structural MRI alterations in children with form-deprivation amblyopia: a propensity score-matched case-control study - a commentary.","authors":"Margaret M Reynolds,Susan M Culican,Jessica B Girault","doi":"10.1136/bjo-2025-328321","DOIUrl":"https://doi.org/10.1136/bjo-2025-328321","url":null,"abstract":"","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"52 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357845","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
AngioReport: dataset and baseline methods for fundus angiography report generation. AngioReport:眼底血管造影报告生成的数据集和基线方法。
IF 3.5 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-23 DOI: 10.1136/bjo-2024-327006
Pusheng Xu, Peranut Chotcomwongse, Weiyi Zhang, Xiaolan Chen, Xinyuan Wu, Florence H T Chung, Xueli Zhang, Mingguang He, Danli Shi, Paisan Ruamviboonsuk

Purpose: To develop an annotated fundus angiographic dataset, including fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA), and establish baseline methods for automatic report generation.

Methods: This retrospective study reviewed patients aged ≥18 years who underwent FFA or ICGA at Rajavithi Hospital, Thailand, between 1 January and 31 December 2019. A total of 55 361 de-identified images from 1691 patients (3179 eyes) were annotated by retinal specialists with detailed descriptions of the type, location, shape, size and pattern of abnormal fluorescence. Two baseline methods were developed: (1) a classification-based approach using ResNet101 with class-specific residual attention for multi-label lesion recognition and (2) a language-generation approach using the Bootstrapping Language-Image Pre-training framework, fine-tuned on angiographic images and structured reports. Model performances were evaluated using F1 score and BERTScore.

Results: The dataset includes 24 diagnostic conditions, with macular neovascularisation (32.5%) being the most prevalent, followed by unremarkable findings (21.8%) and dry age-related macular degeneration (10.2%). Most eyes (81.8%) underwent both FFA and ICGA. Hyperfluorescence was observed in 75.6% of cases, predominantly due to leakage, while hypofluorescence was present in 28.1%. The classification-based method achieved an average score of 7.966, demonstrating superior performance in recognising choroidal neovascularisation, hyperfluorescent and hypofluorescent areas. The language-generation method achieved a comparable average score of 7.947, excelling in impression recognition and the hyperfluorescence identification.

Conclusion: We present the largest annotated fundus angiographic dataset to date, along with two effective baseline methods for automatic report generation, offering a valuable foundation for advancing artificial intelligence applications in ophthalmology.

目的:建立一个带注释的眼底血管造影数据集,包括眼底荧光素血管造影(FFA)和吲哚菁绿血管造影(ICGA),并建立自动生成报告的基线方法。方法:本回顾性研究回顾了2019年1月1日至12月31日期间在泰国Rajavithi医院接受FFA或ICGA治疗的年龄≥18岁的患者。视网膜专家对来自1691名患者(3179只眼睛)的55361张去识别图像进行了注释,详细描述了异常荧光的类型、位置、形状、大小和模式。开发了两种基线方法:(1)基于分类的方法,使用ResNet101具有特定类别的剩余注意用于多标签病变识别;(2)使用Bootstrapping语言图像预训练框架的语言生成方法,对血管造影图像和结构化报告进行微调。采用F1评分和BERTScore对模型性能进行评价。结果:数据集包括24种诊断条件,黄斑新生血管(32.5%)是最普遍的,其次是不显著的发现(21.8%)和干性年龄相关性黄斑变性(10.2%)。大多数(81.8%)眼同时行FFA和ICGA。高荧光在75.6%的病例中观察到,主要是由于渗漏,而低荧光存在于28.1%。基于分类的方法平均得分为7.966分,在识别脉络膜新生血管、高荧光和低荧光区域方面表现优异。语言生成方法的平均得分为7.947分,在印象识别和高荧光识别方面表现优异。结论:我们提供了迄今为止最大的带注释的眼底血管造影数据集,以及两种有效的自动报告生成基线方法,为推进人工智能在眼科中的应用提供了有价值的基础。
{"title":"AngioReport: dataset and baseline methods for fundus angiography report generation.","authors":"Pusheng Xu, Peranut Chotcomwongse, Weiyi Zhang, Xiaolan Chen, Xinyuan Wu, Florence H T Chung, Xueli Zhang, Mingguang He, Danli Shi, Paisan Ruamviboonsuk","doi":"10.1136/bjo-2024-327006","DOIUrl":"10.1136/bjo-2024-327006","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an annotated fundus angiographic dataset, including fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA), and establish baseline methods for automatic report generation.</p><p><strong>Methods: </strong>This retrospective study reviewed patients aged ≥18 years who underwent FFA or ICGA at Rajavithi Hospital, Thailand, between 1 January and 31 December 2019. A total of 55 361 de-identified images from 1691 patients (3179 eyes) were annotated by retinal specialists with detailed descriptions of the type, location, shape, size and pattern of abnormal fluorescence. Two baseline methods were developed: (1) a classification-based approach using ResNet101 with class-specific residual attention for multi-label lesion recognition and (2) a language-generation approach using the Bootstrapping Language-Image Pre-training framework, fine-tuned on angiographic images and structured reports. Model performances were evaluated using F1 score and BERTScore.</p><p><strong>Results: </strong>The dataset includes 24 diagnostic conditions, with macular neovascularisation (32.5%) being the most prevalent, followed by unremarkable findings (21.8%) and dry age-related macular degeneration (10.2%). Most eyes (81.8%) underwent both FFA and ICGA. Hyperfluorescence was observed in 75.6% of cases, predominantly due to leakage, while hypofluorescence was present in 28.1%. The classification-based method achieved an average score of 7.966, demonstrating superior performance in recognising choroidal neovascularisation, hyperfluorescent and hypofluorescent areas. The language-generation method achieved a comparable average score of 7.947, excelling in impression recognition and the hyperfluorescence identification.</p><p><strong>Conclusion: </strong>We present the largest annotated fundus angiographic dataset to date, along with two effective baseline methods for automatic report generation, offering a valuable foundation for advancing artificial intelligence applications in ophthalmology.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1283-1288"},"PeriodicalIF":3.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559280","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
Efficacy comparison of atropine, orthokeratology and repeated low-level red-light therapy for myopia control in children: a systematic review and network meta-analysis. 阿托品、角膜塑形镜和重复低强度红光治疗控制儿童近视的疗效比较:系统评价和网络荟萃分析。
IF 3.5 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-23 DOI: 10.1136/bjo-2025-327366
Zetong Zheng, Xue Jiang, Rongxin Chen, Li Dong

Objectives: This study aimed to compare the efficacy of different interventions for myopia control in children, including 0.01% atropine (AP), orthokeratology (Ortho-k), and repeated low-level red-light therapy (RLRL), and their combinations by conducting a network meta-analysis.

Methods: We searched for randomised controlled trials (RCTs) in PubMed, Web of Science and Embase. The primary outcomes were the mean changes in the cycloplegic spherical equivalent (SE) and axial length (AL) at the 12-month follow-up. A Bayesian random-effects network meta-analysis was performed to estimate pooled weighted mean differences and 95% credible intervals.

Results: The analysis included 41 RCTs with 6434 eyes. Compared with the control group, all interventions were found to be effective at slowing myopia progression, combining direct and indirect evidence at the 12-month follow-up: RLRL therapy (AL -0.31 (0.39, 0.24), p<0.05; SE 0.76 (0.54, 0.98), p<0.05), 0.01% atropine (AL -0.13 (-0.20, 0.07), p<0.05; SE 0.25 (0.08, 0.42), p<0.05), Ortho-k therapy (AL -0.16 (-0.26, 0.06), p<0.05; SE 0.58 (0.05, 1.13), p<0.05) and 0.01% atropine+Ortho-k therapy (AL -0.27 (-0.38, 0.16), p<0.05; SE 0.76 (0.23, 1.31), p<0.05). The cumulative probability ranking suggested that RLRL therapy was the most effective intervention in slowing AL, followed by 0.01% atropine+Ortho-k, Ortho-k and 0.01% atropine.

Conclusions: This network meta-analysis provides evidence that RLRL, 0.01% atropine, Ortho-k and 0.01% atropine+Ortho-k are all effective in suppressing myopia progress. In terms of long-term treatment efficacy in slowing AL and SE procession, RLRL was the most effective intervention.

目的:本研究通过网络meta分析,比较0.01%阿托品(AP)、角膜塑形术(Ortho-k)和重复低强度红光治疗(RLRL)等不同干预措施及其组合对儿童近视控制的效果。方法:我们在PubMed、Web of Science和Embase中检索随机对照试验(RCTs)。主要结果是在12个月的随访中,睫状体麻痹球当量(SE)和轴长(AL)的平均变化。采用贝叶斯随机效应网络进行meta分析,估计合并加权平均差异和95%可信区间。结果:纳入41项随机对照试验,6434只眼。与对照组相比,所有干预措施均有效减缓近视进展,结合12个月随访的直接和间接证据:RLRL治疗(AL -0.31(0.39, 0.24)),结论:本网络荟萃分析提供了RLRL、0.01%阿托品、Ortho-k和0.01%阿托品+Ortho-k均有效抑制近视进展的证据。从减缓AL和SE的长期治疗效果来看,RLRL是最有效的干预措施。
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引用次数: 0
Predicting the therapeutic effect of photodynamic therapy on circumscribed choroidal haemangioma: a retrospective cohort study. 预测光动力治疗局限性脉络膜血管瘤的疗效:一项回顾性队列研究。
IF 3.5 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2025-10-23 DOI: 10.1136/bjo-2024-326759
Jehwi Jeon, Hyeong Ju Byeon, Suk Ho Byeon, Sung Soo Kim, Christopher Seungkyu Lee

Background/aims: Circumscribed choroidal haemangioma (CCH) can cause visual impairment, primarily managed with photodynamic therapy (PDT). This study aimed to identify predictive factors of therapeutic response in patients with CCH treated with PDT and to analyse serial anatomical outcomes, focusing on visual acuity, tumour characteristics, and inner retinal microstructures.

Methods: This retrospective study included patients diagnosed with CCH at Severance Eye Hospital, Yonsei University, from January 2005 to December 2022. We reviewed patient records and multimodal imaging, assessing demographics, including post-PDT visual acuity changes, age, laterality and sex, and multimodal imaging features such as tumour location and height, presence of subfoveal subretinal fluid (SRF), enhanced reflectivity of the retinal pigment epithelium and external limiting membrane (ELM) disruption.

Results: Among 114 patients with CCH (82 men, 65.6%; mean age 52.1±14.0 years), 45 (39.5%) had asymptomatic CCH, while 69 (60.5%) presented with symptomatic CCH. PDT was administered to 41 symptomatic patients (59.4%). The pretreatment LogMAR visual acuity was 0.50±0.63, which remained stable 1 year after PDT (0.53±0.64, p=0.666). However, it worsened 3 years after PDT (0.81±0.89, p=0.024), around the time tumour regrowth was observed. At 1-year post-PDT, tumour volume and height decreased by an average of 34.6% and 32.4%, respectively, accompanied by a 75.0% reduction in SRF. Patients with >75% vol reduction showed greater SRF persistence, while a higher initial SRF height was associated with complete SRF absorption following PDT. ELM disruption was identified as a significant predictor of poorer visual acuity, reduced tumour volume response and limited SRF absorption.

Conclusions: The presence of SRF predicts favourable tumour size reduction and SRF absorption post-PDT, while ELM disruption serves as an important prognostic factor for visual acuity and structural outcomes, aiding in pre-PDT treatment planning.

背景/目的:局限性脉络膜血管瘤(CCH)可引起视力损害,主要通过光动力疗法(PDT)进行治疗。本研究旨在确定PDT治疗CCH患者治疗反应的预测因素,并分析一系列解剖学结果,重点关注视力、肿瘤特征和视网膜内部显微结构。方法:本回顾性研究纳入2005年1月至2022年12月在延世大学Severance眼科医院诊断为CCH的患者。我们回顾了患者记录和多模态成像,评估了人口统计学特征,包括pdt后视力变化、年龄、侧边和性别,以及多模态成像特征,如肿瘤位置和高度、中央凹下视网膜下液(SRF)的存在、视网膜色素上皮反射率增强和外限制膜(ELM)破坏。结果:114例CCH患者中,男性82例,占65.6%;平均年龄52.1±14.0岁),无症状CCH 45例(39.5%),有症状CCH 69例(60.5%)。有症状的患者41例(59.4%)接受PDT治疗。术前LogMAR视力为0.50±0.63,PDT后1年保持稳定(0.53±0.64,p=0.666)。然而,PDT后3年恶化(0.81±0.89,p=0.024),大约是肿瘤再生的时间。pdt后1年,肿瘤体积和高度分别平均下降34.6%和32.4%,SRF下降75.0%。体积减少75%的患者表现出更大的SRF持久性,而更高的初始SRF高度与PDT后SRF的完全吸收有关。ELM破坏被确定为视力较差、肿瘤体积反应减少和SRF吸收有限的重要预测因子。结论:SRF的存在预示着pdt后有利的肿瘤大小缩小和SRF吸收,而ELM破坏是视力和结构结局的重要预后因素,有助于pdt前的治疗计划。
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引用次数: 0
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British Journal of Ophthalmology
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