Yanping Chen,Wei Wang,Ruilin Xiong,Fang Yu,Shaoxin Pan,Jing Dong,Jian Zhang,Zhuoting Zhu,Xiaohu Ding,Bin Wang,Yanxian Chen,Henry Ho-Lung Chan,Kai Yip Choi,Sonia Seen Hang Chan,Yingfeng Zheng,Danli Shi,Yuri Aung,Shoji Kishi,Kyoko Ohno-Matsui,Mingguang He
BACKGROUNDTo evaluate the efficacy and safety of repeated low-level red-light (RLRL) therapy for controlling myopia progression over 3 years in real-world settings.METHODSThis multicentre cohort study included participants currently undergoing RLRL treatment, identified from electronic medical databases in three hospitals (myopic children and adolescents aged 7-18 years, who were prescribed RLRL therapy from 1 June 2018 to 1 June 2023), using stratified random sampling based on RLRL treatment duration (≥0.5-1 year, ≥1-2 years, ≥2-3 years and ≥3 years), with approximately 90 participants in each group. All participants voluntarily received RLRL therapy twice a daily (3 min/session, ≥4-hour interval), 5-7 days/week.RESULTSAmong 362 participants, 90 were treated for ≥0.5-1 year (median 0.64 year), 91 for ≥1-2 years (median 1.40 years), 90 for ≥2-3 years (median 2.30 years) and 91 for ≥3 years (median 3.65 years). The satisfactory myopia control rate (defined as annual axial elongation ≤0.10 mm) was 72.53% (95% CI 62.17 to 81.37) over ≥3 years of RLRL treatment, with annual axial length change of 0.06 mm/year (95% CI 0.03 to 0.08). No subjective visual function damage was documented by best-corrected visual acuity, and no treatment duration-dependent changes in objective full-field electroretinogram were observed. A minimal, reversible optical coherence tomography change was noted in four eyes which did not impact visual function.CONCLUSIONSThis real-world study demonstrates that RLRL therapy provides promising long-term efficacy and safety in myopia control over 3 years among Chinese myopic children and adolescents.TRIAL REGISTRATION NUMBERNCT05871840.
背景：在现实环境中，评估重复低水平红灯（RLRL）治疗在3年内控制近视进展的有效性和安全性。方法本多中心队列研究纳入3家医院电子医学数据库中目前正在接受RLRL治疗的参与者（7-18岁近视儿童和青少年，于2018年6月1日至2023年6月1日接受RLRL治疗），采用基于RLRL治疗持续时间（≥0.5-1年、≥1-2年、≥2-3年和≥3年）的分层随机抽样，每组约90名参与者。所有参与者自愿接受RLRL治疗，每天2次（3分钟/次，间隔≥4小时），5-7天/周。结果362例患者中，≥0.5-1年90例（中位0.64年），≥1-2年91例（中位1.40年），≥2-3年90例（中位2.30年），≥3年91例（中位3.65年）。在RLRL治疗≥3年期间，满意的近视控制率（定义为年轴长≤0.10 mm）为72.53% (95% CI 62.17 ~ 81.37)，年轴长变化为0.06 mm/年（95% CI 0.03 ~ 0.08）。最佳矫正视力未见主观视功能损害，客观全视场视网膜电图未见治疗持续时间依赖性改变。最小的，可逆的光学相干断层扫描改变被注意到在四只眼睛，不影响视觉功能。结论RLRL治疗在中国近视儿童和青少年中具有3年以上的长期疗效和安全性。试验注册号05871840。
{"title":"Three-year efficacy and safety of repeated low-level red-light therapy for myopia control: a multicentre real-world study.","authors":"Yanping Chen,Wei Wang,Ruilin Xiong,Fang Yu,Shaoxin Pan,Jing Dong,Jian Zhang,Zhuoting Zhu,Xiaohu Ding,Bin Wang,Yanxian Chen,Henry Ho-Lung Chan,Kai Yip Choi,Sonia Seen Hang Chan,Yingfeng Zheng,Danli Shi,Yuri Aung,Shoji Kishi,Kyoko Ohno-Matsui,Mingguang He","doi":"10.1136/bjo-2025-328687","DOIUrl":"https://doi.org/10.1136/bjo-2025-328687","url":null,"abstract":"BACKGROUNDTo evaluate the efficacy and safety of repeated low-level red-light (RLRL) therapy for controlling myopia progression over 3 years in real-world settings.METHODSThis multicentre cohort study included participants currently undergoing RLRL treatment, identified from electronic medical databases in three hospitals (myopic children and adolescents aged 7-18 years, who were prescribed RLRL therapy from 1 June 2018 to 1 June 2023), using stratified random sampling based on RLRL treatment duration (≥0.5-1 year, ≥1-2 years, ≥2-3 years and ≥3 years), with approximately 90 participants in each group. All participants voluntarily received RLRL therapy twice a daily (3 min/session, ≥4-hour interval), 5-7 days/week.RESULTSAmong 362 participants, 90 were treated for ≥0.5-1 year (median 0.64 year), 91 for ≥1-2 years (median 1.40 years), 90 for ≥2-3 years (median 2.30 years) and 91 for ≥3 years (median 3.65 years). The satisfactory myopia control rate (defined as annual axial elongation ≤0.10 mm) was 72.53% (95% CI 62.17 to 81.37) over ≥3 years of RLRL treatment, with annual axial length change of 0.06 mm/year (95% CI 0.03 to 0.08). No subjective visual function damage was documented by best-corrected visual acuity, and no treatment duration-dependent changes in objective full-field electroretinogram were observed. A minimal, reversible optical coherence tomography change was noted in four eyes which did not impact visual function.CONCLUSIONSThis real-world study demonstrates that RLRL therapy provides promising long-term efficacy and safety in myopia control over 3 years among Chinese myopic children and adolescents.TRIAL REGISTRATION NUMBERNCT05871840.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"87 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005156","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}
Yinon Shapira,Emma Worrell,Andre S Litwin,Raman Malhotra
PURPOSETo identify factors associated with visual function and quality of life (QOL) in cosmetic shell (scleral shell) wearers.METHODSThis nationwide, cross-sectional, multicentre study was conducted across the National Health Service England. Cosmetic shell wearers completed the National Artificial Eye Questionnaire, which incorporated 15 items from the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Multivariate regression assessed associations between QOL scores and patient experiences, routine care, demographics and clinical factors.RESULTSAmong 238 respondents, predictors of the QOL composite score included comfort (β=0.25, p<0.001), age 50-65 (β=-0.20, p<0.05), appearance (β=0.20, p<0.05), perceived polishing benefit (β=-0.15, p<0.05) and congenital aetiology (β=0.15, p<0.05). Comfort was positively associated with all VFQ subscales (p<0.05). Lesser discharge predicted better near vision (β=0.19), and non-visible discharge predicted better social function (β=0.14). Appearance was associated with mental health (β=0.19), role difficulties (β=0.17) and dependency (β=0.27). Motility showed no association. Age 30-50 predicted worse dependency (β=-0.18); congenital aetiology predicted better mental health (β=0.19) and cancer worse role difficulties (β=-0.16). A greater perceived polishing benefit was linked to worse role difficulties (β=-0.16) and dependency (β =-0.12).CONCLUSIONSThis is the first study to evaluate QOL predictors in cosmetic shell wearers. While some factors overlap with artificial eye users, key differences underscore the distinct needs of this group.
{"title":"UK National Artificial Eye Questionnaire study: exploring factors influencing quality of life in cosmetic shell wearers.","authors":"Yinon Shapira,Emma Worrell,Andre S Litwin,Raman Malhotra","doi":"10.1136/bjo-2025-327875","DOIUrl":"https://doi.org/10.1136/bjo-2025-327875","url":null,"abstract":"PURPOSETo identify factors associated with visual function and quality of life (QOL) in cosmetic shell (scleral shell) wearers.METHODSThis nationwide, cross-sectional, multicentre study was conducted across the National Health Service England. Cosmetic shell wearers completed the National Artificial Eye Questionnaire, which incorporated 15 items from the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Multivariate regression assessed associations between QOL scores and patient experiences, routine care, demographics and clinical factors.RESULTSAmong 238 respondents, predictors of the QOL composite score included comfort (β=0.25, p<0.001), age 50-65 (β=-0.20, p<0.05), appearance (β=0.20, p<0.05), perceived polishing benefit (β=-0.15, p<0.05) and congenital aetiology (β=0.15, p<0.05). Comfort was positively associated with all VFQ subscales (p<0.05). Lesser discharge predicted better near vision (β=0.19), and non-visible discharge predicted better social function (β=0.14). Appearance was associated with mental health (β=0.19), role difficulties (β=0.17) and dependency (β=0.27). Motility showed no association. Age 30-50 predicted worse dependency (β=-0.18); congenital aetiology predicted better mental health (β=0.19) and cancer worse role difficulties (β=-0.16). A greater perceived polishing benefit was linked to worse role difficulties (β=-0.16) and dependency (β =-0.12).CONCLUSIONSThis is the first study to evaluate QOL predictors in cosmetic shell wearers. While some factors overlap with artificial eye users, key differences underscore the distinct needs of this group.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"65 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005159","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}
Rana Khalil,Diya Shah,Aman Sutaria,Carina M Luxhøj,Karla Orsine Murta Dias,Harry Petrushkin
PURPOSESince first being introduced over 50 years ago, ophthalmic viscoelastic devices (OVDs) have revolutionised the fields of cataract, cornea and glaucoma surgery, with extensive published anterior segment safety data available. More recently, these devices have also gained popularity in posterior segment surgery, with particular focus on their potential use as long-lasting, non-toxic, biocompatible and biodegradable vitreous substitutes. The most commercially available products are based on hydrophilic polymers such as hyaluronic acid (HA), hydroxypropylmethylcellulose (HPMC) and chondroitin sulfate (CS). This remains a novel area of research, with very few studies examining their long-term safety profile.METHODSWe conducted a systematic review on Medline and Embase via OVID, using key words "viscoelastics" and "intraocular". Both databases were searched from inception date, with no language limitations.RESULTSThere is a paucity of high-quality evidence addressing the long-term safety of OVDs in the eye. A total of 38 studies were included for final review. These studies were unsuitable for any direct head-to-head comparisons; therefore, a descriptive analysis is presented.CONCLUSIONSBy far, HA-based OVDs have been the most well described, with several long-term intraocular applications. They display highly favourable biophysical properties with minimal adverse reactions in short and long-term in vivo, in vitro and animal studies. There is limited safety data on HPMC and CS-based products, despite their popularity. This represents a gap in the literature and invites the need for high-quality evidence to support their continued use, particularly in the realms of vitreoretinal surgery and chronic hypotony.
{"title":"Safety profile of long-term intraocular ophthalmic viscoelastic devices: a systematic review.","authors":"Rana Khalil,Diya Shah,Aman Sutaria,Carina M Luxhøj,Karla Orsine Murta Dias,Harry Petrushkin","doi":"10.1136/bjo-2025-327856","DOIUrl":"https://doi.org/10.1136/bjo-2025-327856","url":null,"abstract":"PURPOSESince first being introduced over 50 years ago, ophthalmic viscoelastic devices (OVDs) have revolutionised the fields of cataract, cornea and glaucoma surgery, with extensive published anterior segment safety data available. More recently, these devices have also gained popularity in posterior segment surgery, with particular focus on their potential use as long-lasting, non-toxic, biocompatible and biodegradable vitreous substitutes. The most commercially available products are based on hydrophilic polymers such as hyaluronic acid (HA), hydroxypropylmethylcellulose (HPMC) and chondroitin sulfate (CS). This remains a novel area of research, with very few studies examining their long-term safety profile.METHODSWe conducted a systematic review on Medline and Embase via OVID, using key words \"viscoelastics\" and \"intraocular\". Both databases were searched from inception date, with no language limitations.RESULTSThere is a paucity of high-quality evidence addressing the long-term safety of OVDs in the eye. A total of 38 studies were included for final review. These studies were unsuitable for any direct head-to-head comparisons; therefore, a descriptive analysis is presented.CONCLUSIONSBy far, HA-based OVDs have been the most well described, with several long-term intraocular applications. They display highly favourable biophysical properties with minimal adverse reactions in short and long-term in vivo, in vitro and animal studies. There is limited safety data on HPMC and CS-based products, despite their popularity. This represents a gap in the literature and invites the need for high-quality evidence to support their continued use, particularly in the realms of vitreoretinal surgery and chronic hypotony.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"48 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005157","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}
BACKGROUND/AIMSThis study evaluates the relationship between the iridotrabecular contact (ITC) index and various anterior segment parameters, with a particular focus on lens-related parameters, given their clinical relevance in primary angle closure disease (PACD).METHODSA retrospective analysis was conducted on consecutive patients with PACD who underwent swept-source anterior segment optical coherence tomography (AS-OCT). All AS-OCT images were manually reviewed. Relative lens vault greater than one-third was defined as 'high vault'." The ability to detect an ITC index ≥50% was assessed using area under the receiver operating characteristic curve (AUROC). Decision tree analysis identified factors influencing the ITC index.RESULTSA total of 376 patients were initially identified, and after applying exclusion criteria, 119 eyes of 119 PACD patients were included in the final analysis. The mean ITC index was 50.2%±30.5%, with a mean relative lens vault of 0.31±0.10. High vault was significantly associated with higher ITC index (p<0.001), and a positive correlation was observed (r=0.451, p<0.001). The angle recess area at 500 µm (ARA 500) parameter had the highest AUROC (0.983) for detecting ITC index ≥50%. Decision tree analysis identified trabecular iris space area at 500 µm and ARA 500 as key factors, but adding relative lens vault did not improve differentiation.CONCLUSIONSA significant correlation exists between relative lens vault and the ITC index in PACD. However, lens vault does not enhance the diagnostic accuracy of angle parameters for identifying the ITC index. Comprehensive evaluation of PACD should include parameters beyond lens measurements.
{"title":"Exploring iridotrabecular contact index and related factors in primary angle closure disease: a swept-source anterior segment OCT study.","authors":"Yoon Jeong,Ki Ho Park,Jin Wook Jeoung","doi":"10.1136/bjo-2024-326725","DOIUrl":"https://doi.org/10.1136/bjo-2024-326725","url":null,"abstract":"BACKGROUND/AIMSThis study evaluates the relationship between the iridotrabecular contact (ITC) index and various anterior segment parameters, with a particular focus on lens-related parameters, given their clinical relevance in primary angle closure disease (PACD).METHODSA retrospective analysis was conducted on consecutive patients with PACD who underwent swept-source anterior segment optical coherence tomography (AS-OCT). All AS-OCT images were manually reviewed. Relative lens vault greater than one-third was defined as 'high vault'.\" The ability to detect an ITC index ≥50% was assessed using area under the receiver operating characteristic curve (AUROC). Decision tree analysis identified factors influencing the ITC index.RESULTSA total of 376 patients were initially identified, and after applying exclusion criteria, 119 eyes of 119 PACD patients were included in the final analysis. The mean ITC index was 50.2%±30.5%, with a mean relative lens vault of 0.31±0.10. High vault was significantly associated with higher ITC index (p<0.001), and a positive correlation was observed (r=0.451, p<0.001). The angle recess area at 500 µm (ARA 500) parameter had the highest AUROC (0.983) for detecting ITC index ≥50%. Decision tree analysis identified trabecular iris space area at 500 µm and ARA 500 as key factors, but adding relative lens vault did not improve differentiation.CONCLUSIONSA significant correlation exists between relative lens vault and the ITC index in PACD. However, lens vault does not enhance the diagnostic accuracy of angle parameters for identifying the ITC index. Comprehensive evaluation of PACD should include parameters beyond lens measurements.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"32 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005168","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}
Francesc Franquesa-Garcia,Barbara Romero-Nuñez,Ruben Martin-Pinardel,Sandro De Zanet,Julio José González-López,Jose Juan Escobar-Barranco,María P Ruiz-Del-Tiempo,Anna Boixadera,Alex Fonollosa,Alba Gómez-Benlloch,Daniel Velazquez-Villoria,José Ignacio Fernández-Vigo,Gonzaga Garay-Aramburu,Alba Parrado-Carrillo,Luis Castillon,Sandra Gómez Sánchez,Francisco Javier Lavid,Carolina Arruabarrena,Marc Figueras-Roca,Carolina Bernal-Morales,Carlos Ciller,Javier Zarranz-Ventura,
AIMTo explore associations between artificial intelligence (AI)-based baseline optical coherence tomography (OCT) fluid compartment quantifications and 12-month visual outcomes in diabetic macular oedema (DME) eyes treated with the intravitreal dexamethasone implant.METHODSThis was a multicentre, real-world, national DME database and associated OCT dataset study. Demographics, visual acuity (VA), treatments and visit data were collected using a validated web-based tool (Fight Retinal Blindness). Fluid compartment quantifications, including intraretinal fluid (IRF) and subretinal fluid (SRF), were measured in nanolitres (nL) using a validated AI tool (Discovery). Univariate and multivariate regression mixed models evaluated associations between anatomical variables and VA outcomes.RESULTSA total of 101 treatment-naïve DME eyes were grouped into quartiles according to their fluid volume for each fluid compartment (Q1: lowest volume, Q4: highest volume). Baseline IRF was associated with greater VA gains at month 12 (+6.34 letters, p=0.07) but poorer final VA (-8.95, p=0.07), while SRF was associated with worse final VA at 12 months (-12.5, p=0.01). At month 3, IRF was associated with a VA decrease at 12 months (-13.7, p=0.02) and lower final VA (-29.8, p<0.001). At month 12, IRF was associated with lower final VA (-11.6, p=0.03). Quantitatively, a reduction of 100 nL of IRF at 3 months was associated with a +1.54 letters gain (p=0.03) in the multivariate analysis.CONCLUSIONThis real-world, multicentre study describes objective baseline fluid volumes that predict visual outcomes at 12 months in routine clinical care. Accurate quantification of baseline fluid volumes may play a predictive role for final visual outcomes.
{"title":"Artificial intelligence-based fluid quantification predicts clinical outcomes in diabetic macular oedema eyes treated with intravitreal dexamethasone implants: DIADEMA project.","authors":"Francesc Franquesa-Garcia,Barbara Romero-Nuñez,Ruben Martin-Pinardel,Sandro De Zanet,Julio José González-López,Jose Juan Escobar-Barranco,María P Ruiz-Del-Tiempo,Anna Boixadera,Alex Fonollosa,Alba Gómez-Benlloch,Daniel Velazquez-Villoria,José Ignacio Fernández-Vigo,Gonzaga Garay-Aramburu,Alba Parrado-Carrillo,Luis Castillon,Sandra Gómez Sánchez,Francisco Javier Lavid,Carolina Arruabarrena,Marc Figueras-Roca,Carolina Bernal-Morales,Carlos Ciller,Javier Zarranz-Ventura, ","doi":"10.1136/bjo-2025-328172","DOIUrl":"https://doi.org/10.1136/bjo-2025-328172","url":null,"abstract":"AIMTo explore associations between artificial intelligence (AI)-based baseline optical coherence tomography (OCT) fluid compartment quantifications and 12-month visual outcomes in diabetic macular oedema (DME) eyes treated with the intravitreal dexamethasone implant.METHODSThis was a multicentre, real-world, national DME database and associated OCT dataset study. Demographics, visual acuity (VA), treatments and visit data were collected using a validated web-based tool (Fight Retinal Blindness). Fluid compartment quantifications, including intraretinal fluid (IRF) and subretinal fluid (SRF), were measured in nanolitres (nL) using a validated AI tool (Discovery). Univariate and multivariate regression mixed models evaluated associations between anatomical variables and VA outcomes.RESULTSA total of 101 treatment-naïve DME eyes were grouped into quartiles according to their fluid volume for each fluid compartment (Q1: lowest volume, Q4: highest volume). Baseline IRF was associated with greater VA gains at month 12 (+6.34 letters, p=0.07) but poorer final VA (-8.95, p=0.07), while SRF was associated with worse final VA at 12 months (-12.5, p=0.01). At month 3, IRF was associated with a VA decrease at 12 months (-13.7, p=0.02) and lower final VA (-29.8, p<0.001). At month 12, IRF was associated with lower final VA (-11.6, p=0.03). Quantitatively, a reduction of 100 nL of IRF at 3 months was associated with a +1.54 letters gain (p=0.03) in the multivariate analysis.CONCLUSIONThis real-world, multicentre study describes objective baseline fluid volumes that predict visual outcomes at 12 months in routine clinical care. Accurate quantification of baseline fluid volumes may play a predictive role for final visual outcomes.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986452","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}
AIMSTo evaluate the effect of Preserflo MicroShunt (PMS) implantation on corneal endothelial cell density (CECD) and to identify factors associated with CECD loss.METHODSThis retrospective study included patients who underwent PMS implantation, with or without combined cataract surgery, between March 2023 and April 2024, with a minimum of 12 months of postoperative follow-up. CECD was measured preoperatively and at 3, 6 and 12 months postoperatively. The primary outcome was the change in CECD after PMS implantation. Secondary analyses included linear regression to estimate annual CECD loss and logistic regression to identify factors associated with CECD reduction.RESULTSIn total, 104 eyes (70 PMS alone, 34 combined with phacoemulsification) were included. Mean CECD (cells/mm²) in PMS-alone group and combined-with-phacoemulsification group were 2312.9±501.7 and 2615.0±365.5 at baseline, 2253.7±530.9 and 2354.4±424.6 at 3 months postoperatively, 2234.6±528.5 and 2374.6±458.9 at 6 months postoperatively and 2149.2±537.5 and 2357.6±508.7 at 12 months postoperatively, respectively. The estimated annual CECD loss was 7.3±11.9% in the PMS-alone group and 8.0±17.2% in the combined-with-phacoemulsification group (p=0.47). Multivariate logistic regression revealed that a narrower tube-cornea angle (TCA) (p=0.01) and higher preoperative IOP (p=0.04) were significantly associated with greater CECD loss.CONCLUSIONSPMS implantation was associated with CECD reduction over 12 months. A narrower TCA and higher preoperative intraocular pressure were significant predictors of CECD loss.
{"title":"Corneal endothelial cell density changes after Preserflo MicroShunt implantation.","authors":"Taro Baba,Osamu Baba,Kikuno Hirose,Naoki Okada,Kana Tokumo,Hirokazu Sakaguchi,Kazuyuki Hirooka","doi":"10.1136/bjo-2025-328495","DOIUrl":"https://doi.org/10.1136/bjo-2025-328495","url":null,"abstract":"AIMSTo evaluate the effect of Preserflo MicroShunt (PMS) implantation on corneal endothelial cell density (CECD) and to identify factors associated with CECD loss.METHODSThis retrospective study included patients who underwent PMS implantation, with or without combined cataract surgery, between March 2023 and April 2024, with a minimum of 12 months of postoperative follow-up. CECD was measured preoperatively and at 3, 6 and 12 months postoperatively. The primary outcome was the change in CECD after PMS implantation. Secondary analyses included linear regression to estimate annual CECD loss and logistic regression to identify factors associated with CECD reduction.RESULTSIn total, 104 eyes (70 PMS alone, 34 combined with phacoemulsification) were included. Mean CECD (cells/mm²) in PMS-alone group and combined-with-phacoemulsification group were 2312.9±501.7 and 2615.0±365.5 at baseline, 2253.7±530.9 and 2354.4±424.6 at 3 months postoperatively, 2234.6±528.5 and 2374.6±458.9 at 6 months postoperatively and 2149.2±537.5 and 2357.6±508.7 at 12 months postoperatively, respectively. The estimated annual CECD loss was 7.3±11.9% in the PMS-alone group and 8.0±17.2% in the combined-with-phacoemulsification group (p=0.47). Multivariate logistic regression revealed that a narrower tube-cornea angle (TCA) (p=0.01) and higher preoperative IOP (p=0.04) were significantly associated with greater CECD loss.CONCLUSIONSPMS implantation was associated with CECD reduction over 12 months. A narrower TCA and higher preoperative intraocular pressure were significant predictors of CECD loss.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"268 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986451","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}
Clare Quigley, James Pietris, Terence Ang, Abdullah Al Mater, Mark Beecher, Angela Oh, Daniel Benson Rootman, Nicholas James Theis, Robert Weatherhead, Reid Ferguson, Stephen Ng, Verona Botha, Ru M Ong, Michael John Davies, Freny Kalapesi, Sarah F Osborne, Kaveh Vahdani, Marie Louise Roed Rasmussen, Steffen Heegaard, Marco Sales-Sanz, Andrés González-García, Timothy J Sullivan, Delia D Wang, Dinesh Selva
Introduction: Vacuoles, E1-ligase, X-linked Auto-inflammatory, Somatic (VEXAS) syndrome is a recently described multisystem inflammatory disorder. Ocular features are described, though not well known; we aimed to describe them.
Methods: This is a case series of VEXAS patients submitted by ophthalmologists from relevant specialty organisations, including the Australian and New Zealand Society of Ophthalmic Plastic Surgeons, British Oculoplastic Surgical Society and the Orbital Society. Patient consent was received.
Results: 14 males with VEXAS syndrome and eye features were included, median age 73 years (range 49-78). The associated UBA1 mutation was most commonly p.Met41Val (n=8, 57%), and most patients were Caucasian (n=11, 79%). All patients reported eyelid swelling (n=14, 100%); the next most frequent symptom was eye pain (n=10, 71%). Eye symptoms showed variable duration at presentation, most commonly 2-7 days (n=6, 43%). Eye involvement was typically bilateral (metachronous n=5, 36%, synchronous n=2, 14%). Overall, visual acuity was normal and did not change. Severe vision loss occurred unilaterally in two patients (14%), due to orbital compartment syndrome and periorbital necrotising fasciitis. Ophthalmologist-reported clinical features included periorbital oedema, present in all cases (n=14, 100%), followed by dacryoadenitis (n=8, 57%) and orbital myositis (n=7, 50%). There were no cases of posterior segment inflammation. Death due to complications of VEXAS occurred in one patient (7%).
Conclusion: Orbital inflammation was a feature in all cases of VEXAS with eye involvement, and severe loss of vision occurred unilaterally in 14%. Ocular complaints in VEXAS patients should prompt urgent ophthalmic assessment.
{"title":"Orbital inflammation in VEXAS syndrome.","authors":"Clare Quigley, James Pietris, Terence Ang, Abdullah Al Mater, Mark Beecher, Angela Oh, Daniel Benson Rootman, Nicholas James Theis, Robert Weatherhead, Reid Ferguson, Stephen Ng, Verona Botha, Ru M Ong, Michael John Davies, Freny Kalapesi, Sarah F Osborne, Kaveh Vahdani, Marie Louise Roed Rasmussen, Steffen Heegaard, Marco Sales-Sanz, Andrés González-García, Timothy J Sullivan, Delia D Wang, Dinesh Selva","doi":"10.1136/bjo-2025-328652","DOIUrl":"https://doi.org/10.1136/bjo-2025-328652","url":null,"abstract":"<p><strong>Introduction: </strong>Vacuoles, E1-ligase, X-linked Auto-inflammatory, Somatic (VEXAS) syndrome is a recently described multisystem inflammatory disorder. Ocular features are described, though not well known; we aimed to describe them.</p><p><strong>Methods: </strong>This is a case series of VEXAS patients submitted by ophthalmologists from relevant specialty organisations, including the Australian and New Zealand Society of Ophthalmic Plastic Surgeons, British Oculoplastic Surgical Society and the Orbital Society. Patient consent was received.</p><p><strong>Results: </strong>14 males with VEXAS syndrome and eye features were included, median age 73 years (range 49-78). The associated <i>UBA1</i> mutation was most commonly p.Met41Val (n=8, 57%), and most patients were Caucasian (n=11, 79%). All patients reported eyelid swelling (n=14, 100%); the next most frequent symptom was eye pain (n=10, 71%). Eye symptoms showed variable duration at presentation, most commonly 2-7 days (n=6, 43%). Eye involvement was typically bilateral (metachronous n=5, 36%, synchronous n=2, 14%). Overall, visual acuity was normal and did not change. Severe vision loss occurred unilaterally in two patients (14%), due to orbital compartment syndrome and periorbital necrotising fasciitis. Ophthalmologist-reported clinical features included periorbital oedema, present in all cases (n=14, 100%), followed by dacryoadenitis (n=8, 57%) and orbital myositis (n=7, 50%). There were no cases of posterior segment inflammation. Death due to complications of VEXAS occurred in one patient (7%).</p><p><strong>Conclusion: </strong>Orbital inflammation was a feature in all cases of VEXAS with eye involvement, and severe loss of vision occurred unilaterally in 14%. Ocular complaints in VEXAS patients should prompt urgent ophthalmic assessment.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984356","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}
Matteo Mario Carlà,Emanuele Crincoli,Fiammetta Catania,Laura De Luca,Federico Giannuzzi,Francesco Boselli,Gloria Gambini,Carlos Mateo,Stanislao Rizzo
BACKGROUND/AIMSTo evaluate and compare the diagnostic capabilities of advanced large language models (LLMs) in interpreting ophthalmological fundus images across diverse pathologies.METHODSWe evaluated eight leading multimodal LLMs (GPT-4.5, Claude 3.7 Sonnet, Grok-2, Deepseek Cognition V2, Qwen2 72B, Gemini 2.0 Pro, Llama 3 405B and Mixtral 8×22B) on their ability to interpret 100 fundus images representing various ophthalmological conditions. Performance was assessed using validated charts for diagnostic accuracy, specificity, sensitivity, consistency, relevance and explanation quality.RESULTSGPT-4.5 achieved the highest overall diagnostic accuracy (65.0%), followed by Gemini 2.0 Pro (63.0%). All models showed varied performance across pathology categories, with rhegmatogenous pathologies being most accurately identified (Gemini 2.0 Pro: 81.3%, GPT-4.5: 75.0%) and myopic maculopathy (mean accuracy 21.8%) being particularly challenging. The remaining models performed significantly worse: Deepseek Cognition V2 (52.0%), Claude 3.7 Sonnet (52.0%), Qwen2 72B (49.0%), Llama 3 405B (48.0%), Grok-2 (47.0%) and Mixtral 8×22B (46.0%). Lower-performing models frequently declined to provide diagnoses, with refusal rates from 8.0% (Claude 3.7 Sonnet) to 19.0% (Mixtral 8×22B).CONCLUSIONCurrent LLMs show promising but limited capabilities in ophthalmological image interpretation. While performance on common conditions like retinal detachments and age-related macular degeneration is moderately good, significant challenges remain with rare conditions, myopic pathologies and complex vascular disorders. The competitive performance between GPT-4.5 and Gemini 2.0 Pro, with each excelling in different pathology categories, suggests that leveraging their complementary strengths might offer improved diagnostic support.
{"title":"Advanced analysis of leading large language models for diagnostic accuracy in retinal imaging.","authors":"Matteo Mario Carlà,Emanuele Crincoli,Fiammetta Catania,Laura De Luca,Federico Giannuzzi,Francesco Boselli,Gloria Gambini,Carlos Mateo,Stanislao Rizzo","doi":"10.1136/bjo-2025-327634","DOIUrl":"https://doi.org/10.1136/bjo-2025-327634","url":null,"abstract":"BACKGROUND/AIMSTo evaluate and compare the diagnostic capabilities of advanced large language models (LLMs) in interpreting ophthalmological fundus images across diverse pathologies.METHODSWe evaluated eight leading multimodal LLMs (GPT-4.5, Claude 3.7 Sonnet, Grok-2, Deepseek Cognition V2, Qwen2 72B, Gemini 2.0 Pro, Llama 3 405B and Mixtral 8×22B) on their ability to interpret 100 fundus images representing various ophthalmological conditions. Performance was assessed using validated charts for diagnostic accuracy, specificity, sensitivity, consistency, relevance and explanation quality.RESULTSGPT-4.5 achieved the highest overall diagnostic accuracy (65.0%), followed by Gemini 2.0 Pro (63.0%). All models showed varied performance across pathology categories, with rhegmatogenous pathologies being most accurately identified (Gemini 2.0 Pro: 81.3%, GPT-4.5: 75.0%) and myopic maculopathy (mean accuracy 21.8%) being particularly challenging. The remaining models performed significantly worse: Deepseek Cognition V2 (52.0%), Claude 3.7 Sonnet (52.0%), Qwen2 72B (49.0%), Llama 3 405B (48.0%), Grok-2 (47.0%) and Mixtral 8×22B (46.0%). Lower-performing models frequently declined to provide diagnoses, with refusal rates from 8.0% (Claude 3.7 Sonnet) to 19.0% (Mixtral 8×22B).CONCLUSIONCurrent LLMs show promising but limited capabilities in ophthalmological image interpretation. While performance on common conditions like retinal detachments and age-related macular degeneration is moderately good, significant challenges remain with rare conditions, myopic pathologies and complex vascular disorders. The competitive performance between GPT-4.5 and Gemini 2.0 Pro, with each excelling in different pathology categories, suggests that leveraging their complementary strengths might offer improved diagnostic support.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971794","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}
Pub Date : 2026-01-14DOI: 10.1136/bjo-2022-321963corr1
{"title":"Correction: Quality assessment of colour fundus and fluorescein angiography images using deep learning.","authors":"","doi":"10.1136/bjo-2022-321963corr1","DOIUrl":"https://doi.org/10.1136/bjo-2022-321963corr1","url":null,"abstract":"","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"39 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971793","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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