Sophie-Christin Kornelia Ernst,Pete R Jones,Gábor Mark Somfai,Matthias D Becker,Jan Henrik Terheyden
Patient-reported outcome measures (PROMs) reflect patients' abilities, difficulties and perceptions, but their use in ophthalmic care in Europe is unclear. We conducted a cross-sectional electronic survey among ophthalmologists in the UK, Germany and Switzerland to assess PROM use in routine care, their perceived value and implementation barriers. Only 31% of 112 respondents reported using PROMs, mostly in cataract care, with no differences across countries or clinical settings. Strikingly, perceived usefulness did not predict adoption. Reported barriers included staff and patient burden and uncertainty about instrument choice. To promote routine use of PROMs in ophthalmology, system-level integration and support are needed.
{"title":"Use of patient-reported outcome measures in everyday clinical practice in ophthalmology: results of a European multicountry survey.","authors":"Sophie-Christin Kornelia Ernst,Pete R Jones,Gábor Mark Somfai,Matthias D Becker,Jan Henrik Terheyden","doi":"10.1136/bjo-2025-328798","DOIUrl":"https://doi.org/10.1136/bjo-2025-328798","url":null,"abstract":"Patient-reported outcome measures (PROMs) reflect patients' abilities, difficulties and perceptions, but their use in ophthalmic care in Europe is unclear. We conducted a cross-sectional electronic survey among ophthalmologists in the UK, Germany and Switzerland to assess PROM use in routine care, their perceived value and implementation barriers. Only 31% of 112 respondents reported using PROMs, mostly in cataract care, with no differences across countries or clinical settings. Strikingly, perceived usefulness did not predict adoption. Reported barriers included staff and patient burden and uncertainty about instrument choice. To promote routine use of PROMs in ophthalmology, system-level integration and support are needed.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"38 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644947","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}
Ji Hong Kim,Yunjin Kim,Kathy Michelle Oraha,Hae Min Park,Yu Jeong Kim,Han Woong Lim,Yoon-Kyoung Sung,Derek S Welsbie,Won June Lee
BACKGROUND/AIMSTo assess the incidence of glaucoma in patients with systemic lupus erythematosus (SLE) and to identify associated risk factors using a nationwide population-based cohort.METHODSThis retrospective cohort study analysed data from the Korean National Health Insurance Service (2008-2022). A total of 9682 patients with SLE were identified using ICD-10 code M32 and rare intractable disease code V136 and matched 1:1 to non-SLE controls by age and sex. The incidence of glaucoma (ICD-10 codes H40 and H42) and glaucoma suspect (H40.0) was assessed. Multivariate logistic regression was used to identify risk factors for glaucoma, including long-term corticosteroid use (≥180 days).RESULTSThe incidence of glaucoma was significantly higher in the SLE group than in controls (11.34% vs 3.74%; p<0.0001), with a greater prevalence in younger patients (<40 years) and females. Glaucoma suspect cases were also more common in the SLE group (35.56% vs 30.25%; p<0.0001). SLE was independently associated with glaucoma (adjusted OR: 2.00, 95% CI 1.69 to 2.38), and prolonged corticosteroid use further increased the risk (OR: 1.75, 95% CI 1.51 to 2.02). Annual incidence trends showed a rising pattern over time, especially among SLE patients.CONCLUSIONSSLE is associated with an increased risk of glaucoma, particularly among younger individuals and females. Prolonged corticosteroid therapy significantly contributes to this risk. These findings support the need for regular ophthalmic screening and judicious corticosteroid management in patients with SLE.
背景/目的：通过一项基于全国人群的队列研究，评估系统性红斑狼疮（SLE）患者青光眼的发病率，并确定相关的危险因素。方法本回顾性队列研究分析了韩国国民健康保险服务（2008-2022）的数据。使用ICD-10代码M32和罕见难治性疾病代码V136识别9682例SLE患者，按年龄和性别与非SLE对照组1:1匹配。评估青光眼（ICD-10代码H40和H42）和疑似青光眼（H40.0）的发生率。多因素logistic回归用于确定青光眼的危险因素，包括长期使用皮质类固醇（≥180天）。结果SLE组青光眼的发病率明显高于对照组（11.34% vs 3.74%, p<0.0001），且年轻患者（<40岁）和女性患病率较高。青光眼疑似病例在SLE组中也更为常见（35.56% vs 30.25%, p<0.0001）。SLE与青光眼独立相关（校正OR: 2.00, 95% CI 1.69 - 2.38），长期使用皮质类固醇进一步增加风险（OR: 1.75, 95% CI 1.51 - 2.02）。随着时间的推移，年发病率呈上升趋势，尤其是SLE患者。结论：ssle与青光眼风险增加有关，尤其是在年轻人和女性中。长期的皮质类固醇治疗显著增加了这种风险。这些发现支持SLE患者定期眼科筛查和明智的皮质类固醇治疗的必要性。
{"title":"Incidence of glaucoma in patients with systemic lupus erythematosus: a nationwide cohort study in South Korea.","authors":"Ji Hong Kim,Yunjin Kim,Kathy Michelle Oraha,Hae Min Park,Yu Jeong Kim,Han Woong Lim,Yoon-Kyoung Sung,Derek S Welsbie,Won June Lee","doi":"10.1136/bjo-2025-327897","DOIUrl":"https://doi.org/10.1136/bjo-2025-327897","url":null,"abstract":"BACKGROUND/AIMSTo assess the incidence of glaucoma in patients with systemic lupus erythematosus (SLE) and to identify associated risk factors using a nationwide population-based cohort.METHODSThis retrospective cohort study analysed data from the Korean National Health Insurance Service (2008-2022). A total of 9682 patients with SLE were identified using ICD-10 code M32 and rare intractable disease code V136 and matched 1:1 to non-SLE controls by age and sex. The incidence of glaucoma (ICD-10 codes H40 and H42) and glaucoma suspect (H40.0) was assessed. Multivariate logistic regression was used to identify risk factors for glaucoma, including long-term corticosteroid use (≥180 days).RESULTSThe incidence of glaucoma was significantly higher in the SLE group than in controls (11.34% vs 3.74%; p<0.0001), with a greater prevalence in younger patients (<40 years) and females. Glaucoma suspect cases were also more common in the SLE group (35.56% vs 30.25%; p<0.0001). SLE was independently associated with glaucoma (adjusted OR: 2.00, 95% CI 1.69 to 2.38), and prolonged corticosteroid use further increased the risk (OR: 1.75, 95% CI 1.51 to 2.02). Annual incidence trends showed a rising pattern over time, especially among SLE patients.CONCLUSIONSSLE is associated with an increased risk of glaucoma, particularly among younger individuals and females. Prolonged corticosteroid therapy significantly contributes to this risk. These findings support the need for regular ophthalmic screening and judicious corticosteroid management in patients with SLE.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582970","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}
Haojie Tong,Caiyun Cao,Shang Shi,Xiaoling Liu,Tingting Li,Shaojun Xu,Xiaoyan Wu,Shuman Tao,Fang-Biao Tao
BACKGROUNDGender disparities in vision impairment (VI) among Chinese children and adolescents persist over time. Assessment and prediction of secular trends and the disease burden associated with this disparity can optimise vision health practices.METHODSWe analysed data from the 2005, 2010, 2014 and 2019 Chinese National Surveys on Students Constitution and Health (CNSSCH), which included 874 640 students aged 7-18 years. Regional environmental factors comprised the Price Constant Index (PCI), health worker density, greenery coverage, intensity of light at night, annual patent grants of three kinds, population density, climate and air quality. Trends in VI burden were assessed and predicted using Chinese standard population and WHO population estimates. Mixed-effects models were employed to evaluate sex-based disparities in regional environmental factors and VI prevalence.RESULTSMale VI patients have surpassed females, with the gender disparity increasing from -8797.9 thousand in 2005 to 5941.9 thousand in 2030. The PCI (β=0, p=0), greenery coverage (β=0, p=0), intensity of light at night (β=0, p=0) and annual patent grants of three kinds (β=0, p<0) were positively associated with VI prevalence. Stronger associations were observed between VI in male and both PCI (male: β=0, p=0.; female: β=0, p=0) and annual patent grants of three kinds (male: β=0, p<0; female: β=0, p<0).CONCLUSIONSIn China, VI is more prevalent in females, yet the absolute number of patients is larger in males, with this disparity progressively increasing. Males demonstrate heightened susceptibility to regional environmental factors. These findings support incorporating sex-specific prevention measures into current vision protection policies.
{"title":"Gender disparities in the burden of vision impairment and regional environmental susceptibility among Chinese children and adolescents.","authors":"Haojie Tong,Caiyun Cao,Shang Shi,Xiaoling Liu,Tingting Li,Shaojun Xu,Xiaoyan Wu,Shuman Tao,Fang-Biao Tao","doi":"10.1136/bjo-2025-328078","DOIUrl":"https://doi.org/10.1136/bjo-2025-328078","url":null,"abstract":"BACKGROUNDGender disparities in vision impairment (VI) among Chinese children and adolescents persist over time. Assessment and prediction of secular trends and the disease burden associated with this disparity can optimise vision health practices.METHODSWe analysed data from the 2005, 2010, 2014 and 2019 Chinese National Surveys on Students Constitution and Health (CNSSCH), which included 874 640 students aged 7-18 years. Regional environmental factors comprised the Price Constant Index (PCI), health worker density, greenery coverage, intensity of light at night, annual patent grants of three kinds, population density, climate and air quality. Trends in VI burden were assessed and predicted using Chinese standard population and WHO population estimates. Mixed-effects models were employed to evaluate sex-based disparities in regional environmental factors and VI prevalence.RESULTSMale VI patients have surpassed females, with the gender disparity increasing from -8797.9 thousand in 2005 to 5941.9 thousand in 2030. The PCI (β=0, p=0), greenery coverage (β=0, p=0), intensity of light at night (β=0, p=0) and annual patent grants of three kinds (β=0, p<0) were positively associated with VI prevalence. Stronger associations were observed between VI in male and both PCI (male: β=0, p=0.; female: β=0, p=0) and annual patent grants of three kinds (male: β=0, p<0; female: β=0, p<0).CONCLUSIONSIn China, VI is more prevalent in females, yet the absolute number of patients is larger in males, with this disparity progressively increasing. Males demonstrate heightened susceptibility to regional environmental factors. These findings support incorporating sex-specific prevention measures into current vision protection policies.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582969","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}
Jeremy C K Tan, Jack Phu, Katharina Bell, Ashish Agar, Jonathan Crowston, Giovanni Montesano
Aim: This study evaluates if characteristics (eg, location, size, volume) of clusters of defects on an initial visual field (VF) test were predictive of a repeatable defect in the subsequent two tests.
Methods: Retrospective cohort study of 197 eyes of 103 patients with healthy, suspect or early glaucoma. Using the initial VF pattern deviation probability grid, we defined the number of clusters (≥1 location of p<5%) and associated size (number of adjoining defect locations) and volume (sum of corresponding total deviation values) for each cluster stratified by the four probability levels (ie, p<5%; p<2%; p<1% and p<0.5%).
Results: Of 4424 locations with a defect of p<5%, only 1189 (26.9%) were repeatable. The size [area under the receiver operating characteristic curve (AUC) 0.80, CI 0.76 to 0.85)] and volume (AUC 0.80, CI 0.76 to 0.85) of clusters were predictive of a repeatable defect within the cluster. The optimal thresholds for predicting a repeatable location within each cluster at 95% specificity based on initial cluster size were >6 locations at p<5%, >4 locations at p<2%, >3 locations at p<1% and >2 locations at p<0.5%. Defining cluster defects by involvement of central or peripheral rim locations improved the predictive value compared with the entire 24-2 grid.
Conclusion: The location, size and volume of clusters of defects on an initial VF test may be predictive of subsequent repeatability. This may help distinguish eyes with a higher risk of repeatable defects.
{"title":"Prediction of repeatable glaucomatous visual field defects based on cluster characteristics.","authors":"Jeremy C K Tan, Jack Phu, Katharina Bell, Ashish Agar, Jonathan Crowston, Giovanni Montesano","doi":"10.1136/bjo-2025-327416","DOIUrl":"10.1136/bjo-2025-327416","url":null,"abstract":"<p><strong>Aim: </strong>This study evaluates if characteristics (eg, location, size, volume) of clusters of defects on an initial visual field (VF) test were predictive of a repeatable defect in the subsequent two tests.</p><p><strong>Methods: </strong>Retrospective cohort study of 197 eyes of 103 patients with healthy, suspect or early glaucoma. Using the initial VF pattern deviation probability grid, we defined the number of clusters (≥1 location of p<5%) and associated size (number of adjoining defect locations) and volume (sum of corresponding total deviation values) for each cluster stratified by the four probability levels (ie, p<5%; p<2%; p<1% and p<0.5%).</p><p><strong>Results: </strong>Of 4424 locations with a defect of p<5%, only 1189 (26.9%) were repeatable. The size [area under the receiver operating characteristic curve (AUC) 0.80, CI 0.76 to 0.85)] and volume (AUC 0.80, CI 0.76 to 0.85) of clusters were predictive of a repeatable defect within the cluster. The optimal thresholds for predicting a repeatable location within each cluster at 95% specificity based on initial cluster size were >6 locations at p<5%, >4 locations at p<2%, >3 locations at p<1% and >2 locations at p<0.5%. Defining cluster defects by involvement of central or peripheral rim locations improved the predictive value compared with the entire 24-2 grid.</p><p><strong>Conclusion: </strong>The location, size and volume of clusters of defects on an initial VF test may be predictive of subsequent repeatability. This may help distinguish eyes with a higher risk of repeatable defects.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"1345-1350"},"PeriodicalIF":3.5,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
María José Fernández Fidalgo,Victoria D Ferigo Ferrel,Yue Wu,Ziyi Qi,Yin-Moe Aung,Yanxian Chen,Zhuoting Zhu,Fernando J Fernández-Velázquez
AIMTo evaluate the 12-month efficacy and safety of repeated low-level red-light (RLRL) therapy combined with orthokeratology (ortho-k) (RCO) for controlling myopia in Spanish children.METHODSIn this single-site, randomised, parallel-group, non-blinded clinical trial (NCT06899139), eligible myopic children aged 10-13 years were recruited and assigned randomly either to the RCO group or the ortho-k group. Follow-up assessments were conducted at 6, 9 and 12 months after baseline. The primary outcome and secondary outcome were the axial length (AL) and macular thickness (MT) changes at 12 months estimated by longitudinal mixed model.RESULTSAll participants (n=26; 11 in the RCO group and 15 in the ortho-k group) were included in the analysis. After 12 months, the adjusted mean AL change was -0.124 mm (95% CI -0.164 to -0.084) in the RCO group, whereas the ortho-k group continued to exhibit a modest axial elongation of 0.102 mm (95% CI 0.068 to 0.136). The adjusted mean difference in AL change was -0.226 mm (95% CI -0.279 to -0.174) between the groups (p<0.001). Additionally, the adjusted mean change in MT showed no significant difference between groups at 12 months. In the RCO group, 80% of children achieved AL shortening >-0.05 mm, whereas no children in the ortho-k group showed AL shortening. No severe adverse events were reported during the study.CONCLUSIONSCombining RLRL therapy with ortho-k is an effective and safe myopia control strategy in Caucasian Spanish children, supporting the potential generalisability of the synergistic effect across diverse ethnic groups.
目的评价反复低强度红灯（RLRL）联合角膜塑形术（ortho-k） （RCO）治疗西班牙儿童近视12个月的疗效和安全性。方法在这项单点、随机、平行组、非盲临床试验（NCT06899139）中，招募符合条件的10-13岁近视儿童，随机分为RCO组和ortho-k组。在基线后6、9和12个月进行随访评估。主要终点和次要终点是通过纵向混合模型估计12个月时的轴长（AL）和黄斑厚度（MT）变化。结果所有受试者（n=26， RCO组11例，ortho-k组15例）均纳入分析。12个月后，RCO组调整后的平均AL变化为-0.124 mm (95% CI -0.164至-0.084)，而ortho-k组继续表现出0.102 mm的适度轴向伸长（95% CI 0.068至0.136）。校正后各组间AL变化的平均差异为-0.226 mm (95% CI -0.279 ~ -0.174) (p-0.05 mm)，而ortho-k组无患儿AL缩短。研究期间未报告严重不良事件。结论RLRL联合ortho-k治疗是一种有效、安全的西班牙高加索儿童近视控制策略，支持了不同种族儿童协同效应的潜在普遍性。
{"title":"Repeated low-level red-light therapy combined with orthokeratology for myopia control in Spain: a randomised controlled study.","authors":"María José Fernández Fidalgo,Victoria D Ferigo Ferrel,Yue Wu,Ziyi Qi,Yin-Moe Aung,Yanxian Chen,Zhuoting Zhu,Fernando J Fernández-Velázquez","doi":"10.1136/bjo-2025-328347","DOIUrl":"https://doi.org/10.1136/bjo-2025-328347","url":null,"abstract":"AIMTo evaluate the 12-month efficacy and safety of repeated low-level red-light (RLRL) therapy combined with orthokeratology (ortho-k) (RCO) for controlling myopia in Spanish children.METHODSIn this single-site, randomised, parallel-group, non-blinded clinical trial (NCT06899139), eligible myopic children aged 10-13 years were recruited and assigned randomly either to the RCO group or the ortho-k group. Follow-up assessments were conducted at 6, 9 and 12 months after baseline. The primary outcome and secondary outcome were the axial length (AL) and macular thickness (MT) changes at 12 months estimated by longitudinal mixed model.RESULTSAll participants (n=26; 11 in the RCO group and 15 in the ortho-k group) were included in the analysis. After 12 months, the adjusted mean AL change was -0.124 mm (95% CI -0.164 to -0.084) in the RCO group, whereas the ortho-k group continued to exhibit a modest axial elongation of 0.102 mm (95% CI 0.068 to 0.136). The adjusted mean difference in AL change was -0.226 mm (95% CI -0.279 to -0.174) between the groups (p<0.001). Additionally, the adjusted mean change in MT showed no significant difference between groups at 12 months. In the RCO group, 80% of children achieved AL shortening >-0.05 mm, whereas no children in the ortho-k group showed AL shortening. No severe adverse events were reported during the study.CONCLUSIONSCombining RLRL therapy with ortho-k is an effective and safe myopia control strategy in Caucasian Spanish children, supporting the potential generalisability of the synergistic effect across diverse ethnic groups.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558983","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}
Sooyeon Choe, Chen Xi, Dong Young Park, Kyung Hae Kang, Ahnul Ha, Su Hwan Kim, Young Kook Kim
Background/Aims Major age-related ocular diseases (ARODs)—glaucoma, degeneration of macula and posterior pole (DMPP) and diabetes mellitus with ophthalmic complications (DOC)—often coexist in ageing populations, but their combined impact on severe visual impairment (VI) remains unclear. This study aimed to determine the coincidence rate of ARODs and evaluate the association between concomitant ARODs and the risk of developing severe VI. Methods This nationwide, longitudinal cohort study used data from the Korea National Health Insurance System (KNHIS) National Health Screening Cohort from 2004 to 2019. Incident ARODs were identified by diagnostic codes combined with medication prescriptions. Severe VI was identified through KNHIS health check-up records and the National Disability Registration. Adjusted HRs (aHRs) and 95% CIs were estimated, adjusting for demographic, behavioural and comorbidities. Results Among 0.5 million participants followed over 7 495 390 person-years, 7296 (1.45%) developed glaucoma, 1051 (0.21%) DMPP and 3062 (0.61%) DOC. Compared with those without AROD, the aHRs for severe VI were 4.78 (95% CI 4.00 to 5.72) for glaucoma, 8.27 (95% CI 5.95 to 11.51) for DMPP and 3.23 (95% CI 2.38 to 4.37) for DOC. A total of 595 individuals (0.12%) developed two or more ARODs. For patients with one AROD, the risk of severe VI (aHR 4.96; 95% CI 4.33 to 5.68) increased 1.93-fold with a second AROD (aHR 9.54; 95% CI 6.37 to 14.30) and 2.54-fold with a third AROD (aHR 12.59; 95% CI 2.32 to 68.44). Conclusion The presence of multiple ARODs significantly elevates the risk of severe VI. These findings emphasise the need for integrated eye care, including prevention of developing additional ARODs. Data may be obtained from a third party and are not publicly available. All data generated and analysed during the current study are available at the National Health Insurance Data Sharing Service (accessed at ).
背景/目的青光眼、黄斑及后极变性（DMPP）和糖尿病伴眼并发症（DOC）等主要年龄相关性眼病（arod）在老年人群中经常共存，但它们对严重视力障碍（VI）的综合影响尚不清楚。本研究旨在确定arod的符合率，并评估合并arod与发生严重VI风险之间的关系。方法这项全国性的纵向队列研究使用了2004年至2019年韩国国民健康保险系统（KNHIS）国民健康筛查队列的数据。通过诊断代码结合药物处方确定事件arod。通过KNHIS健康检查记录和国家残疾登记，确定了严重的VI。经人口统计学、行为和合并症调整后，估计调整后的hr （aHRs）和95% ci。结果在随访的50万名参与者中，7296人（1.45%）发生青光眼，1051人（0.21%）发生DMPP， 3062人（0.61%）发生DOC。与没有AROD的患者相比，青光眼的严重VI的ahr为4.78 (95% CI 4.00 ~ 5.72)， DMPP的ahr为8.27 (95% CI 5.95 ~ 11.51)， DOC的ahr为3.23 （95% CI 2.38 ~ 4.37）。共有595人（0.12%）出现两种或两种以上的arod。对于一次AROD患者，第二次AROD患者发生严重VI的风险（aHR 4.96, 95% CI 4.33 - 5.68）增加1.93倍（aHR 9.54, 95% CI 6.37 - 14.30），第三次AROD患者发生严重VI的风险增加2.54倍（aHR 12.59, 95% CI 2.32 - 68.44）。结论多种arod的存在显著增加了严重VI的风险。这些研究结果强调了综合眼科护理的必要性，包括预防发生其他arod。数据可能会从第三方获得，并且不会公开提供。本研究期间产生和分析的所有数据均可在国家健康保险数据共享服务（访问网址：）获得。
{"title":"Synergistic effects of glaucoma, degeneration of macula and posterior pole, and diabetic ophthalmic complications on vision loss","authors":"Sooyeon Choe, Chen Xi, Dong Young Park, Kyung Hae Kang, Ahnul Ha, Su Hwan Kim, Young Kook Kim","doi":"10.1136/bjo-2025-327643","DOIUrl":"https://doi.org/10.1136/bjo-2025-327643","url":null,"abstract":"Background/Aims Major age-related ocular diseases (ARODs)—glaucoma, degeneration of macula and posterior pole (DMPP) and diabetes mellitus with ophthalmic complications (DOC)—often coexist in ageing populations, but their combined impact on severe visual impairment (VI) remains unclear. This study aimed to determine the coincidence rate of ARODs and evaluate the association between concomitant ARODs and the risk of developing severe VI. Methods This nationwide, longitudinal cohort study used data from the Korea National Health Insurance System (KNHIS) National Health Screening Cohort from 2004 to 2019. Incident ARODs were identified by diagnostic codes combined with medication prescriptions. Severe VI was identified through KNHIS health check-up records and the National Disability Registration. Adjusted HRs (aHRs) and 95% CIs were estimated, adjusting for demographic, behavioural and comorbidities. Results Among 0.5 million participants followed over 7 495 390 person-years, 7296 (1.45%) developed glaucoma, 1051 (0.21%) DMPP and 3062 (0.61%) DOC. Compared with those without AROD, the aHRs for severe VI were 4.78 (95% CI 4.00 to 5.72) for glaucoma, 8.27 (95% CI 5.95 to 11.51) for DMPP and 3.23 (95% CI 2.38 to 4.37) for DOC. A total of 595 individuals (0.12%) developed two or more ARODs. For patients with one AROD, the risk of severe VI (aHR 4.96; 95% CI 4.33 to 5.68) increased 1.93-fold with a second AROD (aHR 9.54; 95% CI 6.37 to 14.30) and 2.54-fold with a third AROD (aHR 12.59; 95% CI 2.32 to 68.44). Conclusion The presence of multiple ARODs significantly elevates the risk of severe VI. These findings emphasise the need for integrated eye care, including prevention of developing additional ARODs. Data may be obtained from a third party and are not publicly available. All data generated and analysed during the current study are available at the National Health Insurance Data Sharing Service (accessed at <https://nhiss.nhis.or.kr/bd/ab/bdaba000eng.do>).","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145536365","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}
Aims To investigate the prevalence and severity of adult myopia progression among highly myopic individuals aged 18–25 years, identify its associated factors and evaluate its association with pathologic myopia (PM). Methods We retrospectively included participants aged 18–25 years with consecutive follow-ups from the Shanghai Child and Adolescent Large-scale Eye Study database. Annual changes of cycloplegic spherical equivalent (ΔSE) and axial length (ΔAL) were calculated. Adult myopia progression is defined as ΔSE ≤−0.50 D/year or ΔAL≥0.10 mm/year. PM was diagnosed based on META-Analysis for Pathologic Myopia criteria (category≥2) and optical coherence tomography (OCT) images. Results Among all included 345 eyes, the mean ΔSE was −0.28 D/year (95% CI −0.31 to −0.20; p<0.001) and 64 (18.6%) were classified as having adult myopia progression. The mean ΔAL was 0.09 mm/year (95% CI 0.09 to 0.10; p<0.001), with axial elongation observed in 138 (40.0%) eyes. Both age (ΔSE: β=0.045, p=0.005; ΔAL: β=−0.015, p<0.001) and baseline AL (ΔSE: β=−0.044, p=0.028; ΔAL: β=0.020, p<0.001) were identified as factors associated with ΔSE and ΔAL. No differences in ΔSE (95% CI –0.08 to 0.11; p=0.759) or ΔAL (95% CI –0.04 to 0.01; p=0.190) were found between PM and non-PM groups, and neither metric improved PM discrimination. Conclusions Among high myopic individuals aged 18–25 years, 18.6% exhibited adult myopia progression and 40.0% showed axial elongation. Age and baseline AL were associated with adult myopia progression, but no clear link was found between adult myopia progression and the development of PM. Data are available upon reasonable request. Data are available upon reasonable request. Following publication, study protocols, statistical code and de-identified participant data may be made available to qualified investigators upon approval by the Shanghai Eye Disease Prevention and Treatment Center.
{"title":"Adult myopia progression in high myopes aged 18–25 years: evidence from a population-based cohort","authors":"Haotian Wu, Zihan Ni, Ziyi Qi, Tianyu Cheng, Tianwei Qian, Lingyi Zhao, Yanjiao Wang, Jinliuxing Yang, Jingjing Wang, Bo Zhang, Xun Xu, Xiangui He","doi":"10.1136/bjo-2025-328046","DOIUrl":"https://doi.org/10.1136/bjo-2025-328046","url":null,"abstract":"Aims To investigate the prevalence and severity of adult myopia progression among highly myopic individuals aged 18–25 years, identify its associated factors and evaluate its association with pathologic myopia (PM). Methods We retrospectively included participants aged 18–25 years with consecutive follow-ups from the Shanghai Child and Adolescent Large-scale Eye Study database. Annual changes of cycloplegic spherical equivalent (ΔSE) and axial length (ΔAL) were calculated. Adult myopia progression is defined as ΔSE ≤−0.50 D/year or ΔAL≥0.10 mm/year. PM was diagnosed based on META-Analysis for Pathologic Myopia criteria (category≥2) and optical coherence tomography (OCT) images. Results Among all included 345 eyes, the mean ΔSE was −0.28 D/year (95% CI −0.31 to −0.20; p<0.001) and 64 (18.6%) were classified as having adult myopia progression. The mean ΔAL was 0.09 mm/year (95% CI 0.09 to 0.10; p<0.001), with axial elongation observed in 138 (40.0%) eyes. Both age (ΔSE: β=0.045, p=0.005; ΔAL: β=−0.015, p<0.001) and baseline AL (ΔSE: β=−0.044, p=0.028; ΔAL: β=0.020, p<0.001) were identified as factors associated with ΔSE and ΔAL. No differences in ΔSE (95% CI –0.08 to 0.11; p=0.759) or ΔAL (95% CI –0.04 to 0.01; p=0.190) were found between PM and non-PM groups, and neither metric improved PM discrimination. Conclusions Among high myopic individuals aged 18–25 years, 18.6% exhibited adult myopia progression and 40.0% showed axial elongation. Age and baseline AL were associated with adult myopia progression, but no clear link was found between adult myopia progression and the development of PM. Data are available upon reasonable request. Data are available upon reasonable request. Following publication, study protocols, statistical code and de-identified participant data may be made available to qualified investigators upon approval by the Shanghai Eye Disease Prevention and Treatment Center.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"174 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145536366","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}
Christina Karakosta, Johannes Birtel, Sarah Thiele, Peter Charbel Issa, Samantha Roshani De Silva
Vitamin A deficiency (VAD) can lead to rod then cone dysfunction. We evaluated fundus autofluorescence (FAF) and optical coherence tomography (OCT) images in patients with confirmed VAD. Five patients (10 eyes) were included, with VAD related to Crohn’s disease (n=4) and deficiency of fat soluble vitamins of unknown cause (n=1). After vitamin A supplementation, mean visual acuity improved from 0.2 to 0.1 logMAR, and the initially observed ellipsoid and interdigitation zone abnormalities on OCT imaging improved, supporting previous reports. In contrast, we describe a lack of normal foveal hypoautofluorescence on FAF imaging, which persisted post-treatment and could also be a useful diagnostic sign. No data are available.
{"title":"Reduced macular pigment in vitamin A deficiency retinopathy","authors":"Christina Karakosta, Johannes Birtel, Sarah Thiele, Peter Charbel Issa, Samantha Roshani De Silva","doi":"10.1136/bjo-2025-328384","DOIUrl":"https://doi.org/10.1136/bjo-2025-328384","url":null,"abstract":"Vitamin A deficiency (VAD) can lead to rod then cone dysfunction. We evaluated fundus autofluorescence (FAF) and optical coherence tomography (OCT) images in patients with confirmed VAD. Five patients (10 eyes) were included, with VAD related to Crohn’s disease (n=4) and deficiency of fat soluble vitamins of unknown cause (n=1). After vitamin A supplementation, mean visual acuity improved from 0.2 to 0.1 logMAR, and the initially observed ellipsoid and interdigitation zone abnormalities on OCT imaging improved, supporting previous reports. In contrast, we describe a lack of normal foveal hypoautofluorescence on FAF imaging, which persisted post-treatment and could also be a useful diagnostic sign. No data are available.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"56 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145509650","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}
Jungyul Park, Jin-Sook Yoon, Hokyung Choung, Helen Lew
Background This study investigated the association between dyslipidaemia and thyroid eye disease (TED) activity and severity using a multicentre dataset from South Korea. Methods A retrospective, multicentre study included adult patients (aged ≥19 years) with TED and elevated thyroid autoantibody levels, including thyroid-stimulating immunoglobulin >140% and thyroid-stimulating hormone-binding inhibitory immunoglobulin >1.5 IU/L. Patients previously treated with systemic steroids were excluded. TED activity was defined by a Clinical Activity Score, and severity was categorised as mild or marked based on the NOSPECS classification. Logistic regression analyses identified associations between lipid profiles and TED activity/severity. Subgroup analysis excluded statin users. Receiver operating characteristic curves determined optimal triglyceride (TG) cut-off values. Results Of 330 patients (71.2% women; mean age, 45.7±13.2 years), elevated TG levels were independently associated with TED activity (OR=1.005, 95% CI 1.001 to 1.008, p=0.011) and severity (OR=1.004, 95% CI 1.001 to 1.007, p=0.014). Optimal TG cut-off values were 104 mg/dL for active TED and 108 mg/dL for marked severity. These associations remained consistent in non-statin users with similar cut-off values. Elevated intraocular pressure and smoking were significantly associated with increased disease severity. Subgroup analysis excluding statin users revealed significant associations of total cholesterol and low-density lipoprotein cholesterol with TED activity. Conclusions Elevated TG levels are significantly associated with TED activity and severity, highlighting the potential clinical value of measuring TG for risk stratification and disease management. Further studies should explore whether TG-lowering interventions improve TED outcomes. Data are available upon reasonable request. Anonymised data from this study are available upon reasonable request. Interested researchers should contact the first author (JP, ophjyp{at}naver.com). Data will be made available after obtaining consent from all researchers involved in the KSOPRS collaborative study. Due to ethical and privacy restrictions, the raw patient data cannot be deposited in a public repository.
本研究使用来自韩国的多中心数据集调查了血脂异常与甲状腺眼病（TED）活动和严重程度之间的关系。方法回顾性、多中心研究纳入了患有TED且甲状腺自身抗体水平升高的成年患者（年龄≥19岁），包括促甲状腺免疫球蛋白>140%和促甲状腺激素结合抑制免疫球蛋白>1.5 IU/L。既往接受全身性类固醇治疗的患者被排除在外。TED活动由临床活动评分定义，严重程度根据NOSPECS分类分为轻度或标记。逻辑回归分析确定了脂质谱与TED活动/严重程度之间的关联。亚组分析排除了他汀类药物使用者。受试者工作特性曲线确定最佳甘油三酯（TG）临界值。在330例患者中（71.2%为女性，平均年龄45.7±13.2岁），TG水平升高与TED活动（OR=1.005, 95% CI 1.001 ~ 1.008, p=0.011）和严重程度（OR=1.004, 95% CI 1.001 ~ 1.007, p=0.014）独立相关。活性TED的最佳TG临界值为104 mg/dL，严重程度为108 mg/dL。这些关联在非他汀类药物使用者中保持一致，具有相似的临界值。眼压升高和吸烟与疾病严重程度增加显著相关。排除他汀类药物使用者的亚组分析显示，总胆固醇和低密度脂蛋白胆固醇与TED活动有显著关联。结论TG水平升高与TED活动和严重程度显著相关，强调了TG测量在危险分层和疾病管理中的潜在临床价值。进一步的研究应该探讨降低tg干预是否能改善TED结果。如有合理要求，可提供资料。本研究的匿名数据可根据合理要求提供。有兴趣的研究人员可以联系第一作者（JP, ophjyp{at}naver.com）。数据将在获得所有参与KSOPRS合作研究的研究人员的同意后提供。由于道德和隐私限制，原始患者数据不能存储在公共存储库中。
{"title":"Triglycerides as a predictor of activity and severity in thyroid eye disease: a multicentre study","authors":"Jungyul Park, Jin-Sook Yoon, Hokyung Choung, Helen Lew","doi":"10.1136/bjo-2025-327637","DOIUrl":"https://doi.org/10.1136/bjo-2025-327637","url":null,"abstract":"Background This study investigated the association between dyslipidaemia and thyroid eye disease (TED) activity and severity using a multicentre dataset from South Korea. Methods A retrospective, multicentre study included adult patients (aged ≥19 years) with TED and elevated thyroid autoantibody levels, including thyroid-stimulating immunoglobulin >140% and thyroid-stimulating hormone-binding inhibitory immunoglobulin >1.5 IU/L. Patients previously treated with systemic steroids were excluded. TED activity was defined by a Clinical Activity Score, and severity was categorised as mild or marked based on the NOSPECS classification. Logistic regression analyses identified associations between lipid profiles and TED activity/severity. Subgroup analysis excluded statin users. Receiver operating characteristic curves determined optimal triglyceride (TG) cut-off values. Results Of 330 patients (71.2% women; mean age, 45.7±13.2 years), elevated TG levels were independently associated with TED activity (OR=1.005, 95% CI 1.001 to 1.008, p=0.011) and severity (OR=1.004, 95% CI 1.001 to 1.007, p=0.014). Optimal TG cut-off values were 104 mg/dL for active TED and 108 mg/dL for marked severity. These associations remained consistent in non-statin users with similar cut-off values. Elevated intraocular pressure and smoking were significantly associated with increased disease severity. Subgroup analysis excluding statin users revealed significant associations of total cholesterol and low-density lipoprotein cholesterol with TED activity. Conclusions Elevated TG levels are significantly associated with TED activity and severity, highlighting the potential clinical value of measuring TG for risk stratification and disease management. Further studies should explore whether TG-lowering interventions improve TED outcomes. Data are available upon reasonable request. Anonymised data from this study are available upon reasonable request. Interested researchers should contact the first author (JP, ophjyp{at}naver.com). Data will be made available after obtaining consent from all researchers involved in the KSOPRS collaborative study. Due to ethical and privacy restrictions, the raw patient data cannot be deposited in a public repository.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"39 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145499548","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}
Dongjin Yeo, Seung Ha Hwang, Sooji Lee, Jinyoung Jeong, Jaehyun Kong, Hayeon Lee, Lee Smith, Jaehyeong Cho, Yesol Yim, Jinseok Lee, Jiseung Kang, Jee Myung Yang, Dong Keon Yon
Background The global burden of blindness and vision loss continues to increase, yet comprehensive analyses of underlying causes remain limited. This study estimated the global and regional burden of blindness-related diseases from 1990 to 2021 and projected trends to 2050 to inform public health strategies. Methods We analysed data from the Global Burden of Disease Study (GBD) 2021 to estimate the prevalence and disability-adjusted life years (DALYs) rates of blindness and vision loss, focusing on six major causes, including glaucoma, cataract, age-related macular degeneration, refraction disorders, near vision loss and other vision loss. We quantified the contribution of risk factors, and future trends were projected to 2050 using GBD’s forecast framework. Results In 2021, the global age-standardised prevalence and DALY rates of blindness were 15 784.3 (95% uncertainty interval (UI), 12 761.4–19 502.3) and 342.8 (224.2–503.6) per 100 000. Although global age-standardised DALY rates remained statistically stable between 1990 and 2021, regional trends varied numerically. Southern sub-Saharan Africa recorded the highest age-standardised prevalence rate in 2021 at 16 741.4 (13 187.8–21 129.5), whereas the highest DALY rate was observed in South Asia at 497.1 (345.3–691.6). While the overall burden of blindness did not differ significantly by sex, glaucoma showed a higher burden in males. From 1990 to 2021, cataract DALY rates attributable to household air pollution decreased by 38.4%, with projections showing stable age-standardised rates through 2050. Conclusions As populations age, the global burden of vision loss is projected to grow, with particularly high impact in lower-sociodemographic index regions such as Southern Sub-Saharan Africa and South Asia. Data are available in a public, open-access repository. The findings from this study were produced using data available in public online repositories or in the published literature, data that are publicly available on request from the data provider, and data that are not publicly available due to restrictions by the data provider and which were used under licence for the current study. Details on data sources can be found on the GHDx website, including information about the data provider and links to where the data can be accessed or requested (where available). To download the data used in these analyses, please visit the Global Health Data Exchange GBD 2021 website at .
{"title":"Global, regional and national burden of major blindness-associated ophthalmologic conditions, 1990–2021, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021","authors":"Dongjin Yeo, Seung Ha Hwang, Sooji Lee, Jinyoung Jeong, Jaehyun Kong, Hayeon Lee, Lee Smith, Jaehyeong Cho, Yesol Yim, Jinseok Lee, Jiseung Kang, Jee Myung Yang, Dong Keon Yon","doi":"10.1136/bjo-2025-327917","DOIUrl":"https://doi.org/10.1136/bjo-2025-327917","url":null,"abstract":"Background The global burden of blindness and vision loss continues to increase, yet comprehensive analyses of underlying causes remain limited. This study estimated the global and regional burden of blindness-related diseases from 1990 to 2021 and projected trends to 2050 to inform public health strategies. Methods We analysed data from the Global Burden of Disease Study (GBD) 2021 to estimate the prevalence and disability-adjusted life years (DALYs) rates of blindness and vision loss, focusing on six major causes, including glaucoma, cataract, age-related macular degeneration, refraction disorders, near vision loss and other vision loss. We quantified the contribution of risk factors, and future trends were projected to 2050 using GBD’s forecast framework. Results In 2021, the global age-standardised prevalence and DALY rates of blindness were 15 784.3 (95% uncertainty interval (UI), 12 761.4–19 502.3) and 342.8 (224.2–503.6) per 100 000. Although global age-standardised DALY rates remained statistically stable between 1990 and 2021, regional trends varied numerically. Southern sub-Saharan Africa recorded the highest age-standardised prevalence rate in 2021 at 16 741.4 (13 187.8–21 129.5), whereas the highest DALY rate was observed in South Asia at 497.1 (345.3–691.6). While the overall burden of blindness did not differ significantly by sex, glaucoma showed a higher burden in males. From 1990 to 2021, cataract DALY rates attributable to household air pollution decreased by 38.4%, with projections showing stable age-standardised rates through 2050. Conclusions As populations age, the global burden of vision loss is projected to grow, with particularly high impact in lower-sociodemographic index regions such as Southern Sub-Saharan Africa and South Asia. Data are available in a public, open-access repository. The findings from this study were produced using data available in public online repositories or in the published literature, data that are publicly available on request from the data provider, and data that are not publicly available due to restrictions by the data provider and which were used under licence for the current study. Details on data sources can be found on the GHDx website, including information about the data provider and links to where the data can be accessed or requested (where available). To download the data used in these analyses, please visit the Global Health Data Exchange GBD 2021 website at <https://ghdx.healthdata.org/gbd-2021>.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"47 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145499423","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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