Edward Barayev, Michael Shapiro, Eran Greenbaum, Yuval Ran, Assaf Gershoni, Gad Dotan
Aims To examine the association between colour vision deficiency (CVD) and other ophthalmic disorders including amblyopia, strabismus and ametropia in a large population study. Methods The retrospective, cross-sectional study included 916 388 Israeli army male recruits who had their premilitary medical assessment at the age of 16–18 years from 2000 to 2020, analysing the prevalence of ophthalmic disorders including amblyopia, strabismus and ametropia in army recruits with CVD compared with all other recruits with normal colour vision. Demographic and socioeconomic data were also collected. Results The prevalence of amblyopia (1.28% vs 0.71%, p<0.001), strabismus (1.09% vs 0.83%, p<0.001) and ametropia (moderate—less than 6.00 diopters, 35.05% vs 30.50%, p<0.001 and high—higher than 6.00 diopters, 3.18% vs 2.30%, p<0.001) were all higher among 28 001 (3.06%) army recruits with CVD compared with all other individuals with normal colour vision. CVD was more common in individuals with a higher socioeconomic status (high 3.15% vs low 2.93%, p<0.001) and varied according to recruits’ origin. It was most frequent in individuals whose mother was born in the former Soviet Union (4.98%) compared with other European countries (3.89%), North America (3.28%), Asia (2.78%) and Ethiopia (1.63%). Conclusion CVD is associated with an increased frequency of amblyopia, strabismus and ametropia, which can all impart vision difficulties besides colour vision impairment alone. Data are available upon reasonable request.
{"title":"Colour vision deficiency is associated with increased prevalence of amblyopia, strabismus and ametropia: a large population study","authors":"Edward Barayev, Michael Shapiro, Eran Greenbaum, Yuval Ran, Assaf Gershoni, Gad Dotan","doi":"10.1136/bjo-2023-324564","DOIUrl":"https://doi.org/10.1136/bjo-2023-324564","url":null,"abstract":"Aims To examine the association between colour vision deficiency (CVD) and other ophthalmic disorders including amblyopia, strabismus and ametropia in a large population study. Methods The retrospective, cross-sectional study included 916 388 Israeli army male recruits who had their premilitary medical assessment at the age of 16–18 years from 2000 to 2020, analysing the prevalence of ophthalmic disorders including amblyopia, strabismus and ametropia in army recruits with CVD compared with all other recruits with normal colour vision. Demographic and socioeconomic data were also collected. Results The prevalence of amblyopia (1.28% vs 0.71%, p<0.001), strabismus (1.09% vs 0.83%, p<0.001) and ametropia (moderate—less than 6.00 diopters, 35.05% vs 30.50%, p<0.001 and high—higher than 6.00 diopters, 3.18% vs 2.30%, p<0.001) were all higher among 28 001 (3.06%) army recruits with CVD compared with all other individuals with normal colour vision. CVD was more common in individuals with a higher socioeconomic status (high 3.15% vs low 2.93%, p<0.001) and varied according to recruits’ origin. It was most frequent in individuals whose mother was born in the former Soviet Union (4.98%) compared with other European countries (3.89%), North America (3.28%), Asia (2.78%) and Ethiopia (1.63%). Conclusion CVD is associated with an increased frequency of amblyopia, strabismus and ametropia, which can all impart vision difficulties besides colour vision impairment alone. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"4 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142600971","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/aims Intravitreal injection (IVT) of anti-vascular endothelial growth factor agents is the standard of care for several retinal diseases but can cause intraocular pressure (IOP) elevations. This study investigates short-term postinjection IOP changes following aflibercept 8 mg and faricimab, compared with aflibercept 2 mg. Methods This observational, prospective study included 90 patients with age-related macular degeneration or diabetic macular oedema, divided into three groups, receiving aflibercept 2 mg, aflibercept 8 mg or faricimab. IOP was measured using an iCare IC200-tonometer preinjection (T0) and at 30 s (T1), 5 min (T2) and 15 min (T3) postinjection. Primary outcomes included IOP changes at the four time points within and between treatment groups. The incidence of transient visual loss requiring paracentesis was recorded. Results All groups experienced a significant IOP increase at T1, with mean IOP increase being 41.47±12.95 mm Hg for aflibercept 2 mg, 43.46±8.97 mm Hg for aflibercept 8 mg and 32.19±11.06 mm Hg for faricimab. By T2, IOP differences were not significant, and by T3, mean IOP returned within normal limits across all groups. Faricimab showed a smaller initial IOP spike than both aflibercept formulations, but this difference was not statistically significant at T2 and T3. Conclusion Transient IOP spikes are observed post-IVT of aflibercept 8 mg and faricimab, with similar trends to aflibercept 2 mg. The initial IOP elevation normalised within 15 min. Faricimab had a lower initial spike, but overall IOP profiles were comparable across different agents. Data are available on reasonable request.
{"title":"Short-term intraocular pressure changes after intravitreal aflibercept 2 mg, aflibercept 8 mg and faricimab: a prospective, comparative study","authors":"Arianna Paris, Giulio Volpe, Kathrin Perruchoud-Ader, Alex Casanova, Moreno Menghini, Gabriela Grimaldi","doi":"10.1136/bjo-2024-326053","DOIUrl":"https://doi.org/10.1136/bjo-2024-326053","url":null,"abstract":"Background/aims Intravitreal injection (IVT) of anti-vascular endothelial growth factor agents is the standard of care for several retinal diseases but can cause intraocular pressure (IOP) elevations. This study investigates short-term postinjection IOP changes following aflibercept 8 mg and faricimab, compared with aflibercept 2 mg. Methods This observational, prospective study included 90 patients with age-related macular degeneration or diabetic macular oedema, divided into three groups, receiving aflibercept 2 mg, aflibercept 8 mg or faricimab. IOP was measured using an iCare IC200-tonometer preinjection (T0) and at 30 s (T1), 5 min (T2) and 15 min (T3) postinjection. Primary outcomes included IOP changes at the four time points within and between treatment groups. The incidence of transient visual loss requiring paracentesis was recorded. Results All groups experienced a significant IOP increase at T1, with mean IOP increase being 41.47±12.95 mm Hg for aflibercept 2 mg, 43.46±8.97 mm Hg for aflibercept 8 mg and 32.19±11.06 mm Hg for faricimab. By T2, IOP differences were not significant, and by T3, mean IOP returned within normal limits across all groups. Faricimab showed a smaller initial IOP spike than both aflibercept formulations, but this difference was not statistically significant at T2 and T3. Conclusion Transient IOP spikes are observed post-IVT of aflibercept 8 mg and faricimab, with similar trends to aflibercept 2 mg. The initial IOP elevation normalised within 15 min. Faricimab had a lower initial spike, but overall IOP profiles were comparable across different agents. Data are available on reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"2 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142600969","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}
Intracellular dark endothelial spots (IDESs) on specular microscopy developed in 78/122 patients (63.9%) after Descemet stripping automated endothelial keratoplasty (DSAEK). Endothelial cell density (ECD) after DSAEK was significantly smaller in eyes with IDES when compared with those without at all time points (p<0.001) despite no significant difference in graft ECD (p=0.43), resulting in an increased rate of endothelial failure (p=0.044). The presence of glaucoma (OR=2.22, p=0.027), iris damage (OR=2.85, p=0.004) and non-Fuchs status (OR=2.37, p=0.018) were identified as risk factors for IDES development. Preoperative total protein level in aqueous humour was significantly higher in eye with endothelial failure than those without (p=0.0057). The data that support the findings of this study are available on request from the corresponding author (TY). The data are not publicly available due to them containing information that could compromise research participant privacy/consent.
{"title":"Intracellular dark spots are associated with endothelial cell loss after Descemet’s stripping automated endothelial keratoplasty","authors":"Yurina Mori-Ogiwara, Yukari Yagi-Yaguchi, Osama Ibrahim, Kazunari Higa, Hirotsugu Kasamatsu, Takahiro Kanda, Daisuke Tomida, Yoshinori Oie, Takahiko Hayashi, Jun Shimazaki, Takefumi Yamaguchi","doi":"10.1136/bjo-2024-325702","DOIUrl":"https://doi.org/10.1136/bjo-2024-325702","url":null,"abstract":"Intracellular dark endothelial spots (IDESs) on specular microscopy developed in 78/122 patients (63.9%) after Descemet stripping automated endothelial keratoplasty (DSAEK). Endothelial cell density (ECD) after DSAEK was significantly smaller in eyes with IDES when compared with those without at all time points (p<0.001) despite no significant difference in graft ECD (p=0.43), resulting in an increased rate of endothelial failure (p=0.044). The presence of glaucoma (OR=2.22, p=0.027), iris damage (OR=2.85, p=0.004) and non-Fuchs status (OR=2.37, p=0.018) were identified as risk factors for IDES development. Preoperative total protein level in aqueous humour was significantly higher in eye with endothelial failure than those without (p=0.0057). The data that support the findings of this study are available on request from the corresponding author (TY). The data are not publicly available due to them containing information that could compromise research participant privacy/consent.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"69 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598087","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}
Kaweh Mansouri, Harsha Laxmana Rao, Robert N Weinreb
Objective To evaluate nyctohemeral effects of topical beta-adrenoceptor blocking agents and their fixed combinations on intraocular pressure (IOP) in patients with primary open-angle glaucoma implanted with an ocular telemetry sensor. Methods 22 patients who had previously been implanted with a sulcus-based IOP sensor (eyemate) were included in this prospective clinical trial. Three classes of medications were analysed: beta-blockers (BB), fixed combination of BB and carbonic anhydrase inhibitors (BB-CAI), and combinations of BB and prostaglandin analogues (BB-PGAs). SD and IQR of IOP were calculated and used as surrogates of nyctohemeral IOP variation. Results The mean (±SD) age of patients was 67.8±6.8 years (36.4% female). A total of 50 920 IOP measurements over 4084 days from 10 eyes were included. The mean 24-hour IOP (±SE) with BB-PGA (17.3±1.1 mm Hg) was significantly (p<0.001) less than that with BB (18.8±1.1 mm Hg). Mean 24-hour IOP with BB-CAI (18.4±1.1 mm Hg) was similar (p>0.05) to that with the other two medications. Mean 24-hour SD of IOP with BB-PGA (1.9±0 .2 mm Hg) and BB-CAI (2.0±0.2 mm Hg) were significantly (p<0.05) less than that with BB (2.4±0.2 mm Hg). Mean 24-hour IQR of IOP with BB-PGA (2.3±0.4 mm Hg) was significantly less than that with both BB (3.8±0.4 mm Hg) and BB-CAI (3.2±0.4 mm Hg). Conclusion Continual IOP monitoring shows that combinations of BB-PGAs have more pronounced effects on lowering 24-hour IOP fluctuations than BB-CAIs and BBs alone. Trial registration number [NCT03651336][1]. All data relevant to the study are included in the article or uploaded as online supplemental information. Not applicable. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03651336&atom=%2Fbjophthalmol%2Fearly%2F2024%2F11%2F06%2Fbjo-2023-324760.atom
目的 评估外用β肾上腺素受体阻滞剂及其固定组合对植入眼球遥测传感器的原发性开角型青光眼患者眼压（IOP）的短暂影响。方法 将 22 名曾植入眼底沟眼压传感器（eyemate）的患者纳入这项前瞻性临床试验。分析了三类药物：β-受体阻滞剂（BB）、BB 和碳酸酐酶抑制剂的固定组合（BB-CAI）以及 BB 和前列腺素类似物的组合（BB-PGAs）。计算眼压的 SD 值和 IQR 值，并将其作为短暂眼压变化的代用指标。结果 患者的平均年龄（±SD）为 67.8±6.8 岁（36.4% 为女性）。共纳入了 10 只眼睛在 4084 天内进行的 50 920 次眼压测量。使用 BB-PGA 的 24 小时平均眼压（±SE）（17.3±1.1 mm Hg）与使用其他两种药物的 24 小时平均眼压（±SE）相比有显著差异（P0.05）。使用 BB-PGA（1.9±0.2 mm Hg）和 BB-CAI（2.0±0.2 mm Hg）的 24 小时平均眼压 SD 明显低于使用 BB（2.4±0.2 mm Hg）（P<0.05）。使用 BB-PGA 的 24 小时平均 IQR 眼压（2.3±0.4 mm Hg）明显低于使用 BB（3.8±0.4 mm Hg）和 BB-CAI（3.2±0.4 mm Hg）。结论 持续的眼压监测显示，BB-PGAs 组合在降低 24 小时眼压波动方面的效果比单独使用 BB-CAIs 和 BBs 更明显。试验注册号[NCT03651336][1]。与研究相关的所有数据均包含在文章中或作为在线补充信息上传。不适用。[1]:/lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03651336&atom=%2Fbjophthalmol%2Fearly%2F2024%2F11%2F06%2Fbjo-2023-324760.atom
{"title":"Nyctohemeral effects of topical beta-adrenoceptor blocking agents measured with an intraocular telemetry sensor","authors":"Kaweh Mansouri, Harsha Laxmana Rao, Robert N Weinreb","doi":"10.1136/bjo-2023-324760","DOIUrl":"https://doi.org/10.1136/bjo-2023-324760","url":null,"abstract":"Objective To evaluate nyctohemeral effects of topical beta-adrenoceptor blocking agents and their fixed combinations on intraocular pressure (IOP) in patients with primary open-angle glaucoma implanted with an ocular telemetry sensor. Methods 22 patients who had previously been implanted with a sulcus-based IOP sensor (eyemate) were included in this prospective clinical trial. Three classes of medications were analysed: beta-blockers (BB), fixed combination of BB and carbonic anhydrase inhibitors (BB-CAI), and combinations of BB and prostaglandin analogues (BB-PGAs). SD and IQR of IOP were calculated and used as surrogates of nyctohemeral IOP variation. Results The mean (±SD) age of patients was 67.8±6.8 years (36.4% female). A total of 50 920 IOP measurements over 4084 days from 10 eyes were included. The mean 24-hour IOP (±SE) with BB-PGA (17.3±1.1 mm Hg) was significantly (p<0.001) less than that with BB (18.8±1.1 mm Hg). Mean 24-hour IOP with BB-CAI (18.4±1.1 mm Hg) was similar (p>0.05) to that with the other two medications. Mean 24-hour SD of IOP with BB-PGA (1.9±0 .2 mm Hg) and BB-CAI (2.0±0.2 mm Hg) were significantly (p<0.05) less than that with BB (2.4±0.2 mm Hg). Mean 24-hour IQR of IOP with BB-PGA (2.3±0.4 mm Hg) was significantly less than that with both BB (3.8±0.4 mm Hg) and BB-CAI (3.2±0.4 mm Hg). Conclusion Continual IOP monitoring shows that combinations of BB-PGAs have more pronounced effects on lowering 24-hour IOP fluctuations than BB-CAIs and BBs alone. Trial registration number [NCT03651336][1]. All data relevant to the study are included in the article or uploaded as online supplemental information. Not applicable. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03651336&atom=%2Fbjophthalmol%2Fearly%2F2024%2F11%2F06%2Fbjo-2023-324760.atom","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"36 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142596942","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}
Zhi-Da Soh, Mingrui Tan, Zann Lee, Marco Yu, Sahil Thakur, Raghavan Lavanya, Monisha Esther Nongpiur, Xinxing Xu, Victor Koh, Tin Aung, Yong Liu, Ching-Yu Cheng
Background/ Aims The lack of context for anterior segment optical coherence tomography (ASOCT) measurements impedes its clinical utility. We established the normative distribution of anterior chamber depth (ACD), area (ACA) and width (ACW) and lens vault (LV), and applied percentile cut-offs to detect primary angle closure disease (PACD; ≥180° posterior trabecular meshwork occluded). Methods We included subjects from the Singapore Chinese Eye Study with ASOCT scans. Eyes with ocular surgery or laser procedures, and ocular trauma were excluded. A deep-learning algorithm was used to obtain Visante ASOCT (Carl Zeiss Meditec, USA) measurements. Normative distribution was established using 80% of eyes with open angles. Multivariable logistic regression was performed on 80% open and 80% angle closure eyes. Diagnostic performance was evaluated using 20% open and 20% angle closure eyes. Results We included 2157 eyes (1853 open angles; 304 angle closure) for analysis. ACD, ACA and ACW decreased with age and were smaller in females, and vice versa for LV (all p<0.022). ACD 20th percentile and LV 85th percentile had a balanced accuracy of 84.4% and 84.2% in detecting PACD, respectively. When combined, ACD 20th and LV 85th percentile had 88.68% sensitivity and 88.85% specificity in detecting PACD as compared with a multivariable regression model (ACA, angle opening distance, LV, iris area) with 88.33% sensitivity and 83.75% specificity. Conclusion Anterior chamber parameters varied with age and gender. The ACD 20th and LV 85th percentile values may be used in silos or in combination to detect PACD in the absence of more sophisticated classification algorithms. Data are available on reasonable request. The data included in this study are not publicly available due to patient privacy and the data are meant for research purposes only. On reasonable request, de-identified data used in this study may be made available for academic purpose by the Singapore Eye Research Institute (SERI), subjected to approval by the local institutional review board. Data request can be sent to the Data Access Committee at SERI via seri@seri.com.sg. Any data that can be shared will be released via a Research Collaboration Agreement (RCA) for non-commercial research purpose.
{"title":"Deep learning-based normative database of anterior chamber dimensions for angle closure assessment: the Singapore Chinese Eye Study","authors":"Zhi-Da Soh, Mingrui Tan, Zann Lee, Marco Yu, Sahil Thakur, Raghavan Lavanya, Monisha Esther Nongpiur, Xinxing Xu, Victor Koh, Tin Aung, Yong Liu, Ching-Yu Cheng","doi":"10.1136/bjo-2024-325602","DOIUrl":"https://doi.org/10.1136/bjo-2024-325602","url":null,"abstract":"Background/ Aims The lack of context for anterior segment optical coherence tomography (ASOCT) measurements impedes its clinical utility. We established the normative distribution of anterior chamber depth (ACD), area (ACA) and width (ACW) and lens vault (LV), and applied percentile cut-offs to detect primary angle closure disease (PACD; ≥180° posterior trabecular meshwork occluded). Methods We included subjects from the Singapore Chinese Eye Study with ASOCT scans. Eyes with ocular surgery or laser procedures, and ocular trauma were excluded. A deep-learning algorithm was used to obtain Visante ASOCT (Carl Zeiss Meditec, USA) measurements. Normative distribution was established using 80% of eyes with open angles. Multivariable logistic regression was performed on 80% open and 80% angle closure eyes. Diagnostic performance was evaluated using 20% open and 20% angle closure eyes. Results We included 2157 eyes (1853 open angles; 304 angle closure) for analysis. ACD, ACA and ACW decreased with age and were smaller in females, and vice versa for LV (all p<0.022). ACD 20th percentile and LV 85th percentile had a balanced accuracy of 84.4% and 84.2% in detecting PACD, respectively. When combined, ACD 20th and LV 85th percentile had 88.68% sensitivity and 88.85% specificity in detecting PACD as compared with a multivariable regression model (ACA, angle opening distance, LV, iris area) with 88.33% sensitivity and 83.75% specificity. Conclusion Anterior chamber parameters varied with age and gender. The ACD 20th and LV 85th percentile values may be used in silos or in combination to detect PACD in the absence of more sophisticated classification algorithms. Data are available on reasonable request. The data included in this study are not publicly available due to patient privacy and the data are meant for research purposes only. On reasonable request, de-identified data used in this study may be made available for academic purpose by the Singapore Eye Research Institute (SERI), subjected to approval by the local institutional review board. Data request can be sent to the Data Access Committee at SERI via seri@seri.com.sg. Any data that can be shared will be released via a Research Collaboration Agreement (RCA) for non-commercial research purpose.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"63 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563068","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 This study aimed to characterise imaging artefacts in the lacrimal gland using swept-source optical coherence tomography (SS-OCT) in patients with dry eye disease (DED) and healthy participants and identify risk factors for these artefacts. Methods In total, 151 eyes, including 104 from patients with DED and 47 from non-DED participants, were analysed. Demographic data collection, comprehensive ocular examinations and SS-OCT imaging of the palpebral lobe of the lacrimal gland were performed. Artefacts were classified into distinct categories with different severities. Univariate and multivariate logistic regression analyses were performed to evaluate the association of age, gender, best-corrected visual acuity, intraocular pressure (IOP) and the presence of DED with the presence of artefacts. Results Eight artefact types and severity grading were defined by analysing 1208 lacrimal SS-OCT images. The three most prevalent artefacts were defocus (75.83%), cliff (67.47%) and Z-off (58.44%). The presence of artefacts was significantly associated with the presence of DED (OR=9.13; 95% CI, 2.39 to 34.88; p=0.001) and higher IOP (OR=1.34; 95% CI, 1.14 to 1.58; p<0.001). Furthermore, multivariate logistic analyses showed that lower tear film breakup time (OR=0.71; 95% CI, 0.55 to 0.92; p=0.009) and higher meibum quality score (OR=2.86; 95% CI, 1.49 to 5.48; p=0.002) were significantly associated with higher odds for the presence of artefacts. Conclusions DED eyes had more SS-OCT image artefacts than normal eyes. Stringent standardised image quality control should be implemented before further image analysis when using SS-OCT to assess lacrimal gland image. Data are available upon reasonable request.
{"title":"In vivo lacrimal gland imaging artefact assessment based on swept-source optical coherence tomography for dry eye disease","authors":"Weijing Cheng, Longyue Li, Juejing Chen, Ziyan Chen, Jing Li, Siyi Liu, Nuan Zhang, Feng Gu, Wenhui Wang, Wei Wang, Boyu Yang, Lingyi Liang","doi":"10.1136/bjo-2024-325864","DOIUrl":"https://doi.org/10.1136/bjo-2024-325864","url":null,"abstract":"Background This study aimed to characterise imaging artefacts in the lacrimal gland using swept-source optical coherence tomography (SS-OCT) in patients with dry eye disease (DED) and healthy participants and identify risk factors for these artefacts. Methods In total, 151 eyes, including 104 from patients with DED and 47 from non-DED participants, were analysed. Demographic data collection, comprehensive ocular examinations and SS-OCT imaging of the palpebral lobe of the lacrimal gland were performed. Artefacts were classified into distinct categories with different severities. Univariate and multivariate logistic regression analyses were performed to evaluate the association of age, gender, best-corrected visual acuity, intraocular pressure (IOP) and the presence of DED with the presence of artefacts. Results Eight artefact types and severity grading were defined by analysing 1208 lacrimal SS-OCT images. The three most prevalent artefacts were defocus (75.83%), cliff (67.47%) and Z-off (58.44%). The presence of artefacts was significantly associated with the presence of DED (OR=9.13; 95% CI, 2.39 to 34.88; p=0.001) and higher IOP (OR=1.34; 95% CI, 1.14 to 1.58; p<0.001). Furthermore, multivariate logistic analyses showed that lower tear film breakup time (OR=0.71; 95% CI, 0.55 to 0.92; p=0.009) and higher meibum quality score (OR=2.86; 95% CI, 1.49 to 5.48; p=0.002) were significantly associated with higher odds for the presence of artefacts. Conclusions DED eyes had more SS-OCT image artefacts than normal eyes. Stringent standardised image quality control should be implemented before further image analysis when using SS-OCT to assess lacrimal gland image. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563277","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}
In patients with keratoconus, the classification of the severity stage assessed by anterior segment optical coherence tomography was a reliable predictor for success in big bubble formation during deep anterior lamellar keratoplasty. This study adds to existing evidence that unilateral corneal disease or surgical trauma can affect the homeostasis of the contralateral cornea. In this study, significant morphological and quantitative changes were observed in the sub-basal nerve plexus of the cornea in the unoperated eyes of patients after refractive surgery. This was accompanied by changes in dry eye parameters and neuromediators in tear fluid. The health-related quality of life (HRQOL) impairment associated with dry eye symptoms (DES) was greater than that caused by the confounding comorbidities. The most affected HRQOL dimensions varied between patients with different severities of DES. The glued amniotic membrane transplantation …
{"title":"At a glance","authors":"Frank Larkin","doi":"10.1136/bjo-2024-326599","DOIUrl":"https://doi.org/10.1136/bjo-2024-326599","url":null,"abstract":"In patients with keratoconus, the classification of the severity stage assessed by anterior segment optical coherence tomography was a reliable predictor for success in big bubble formation during deep anterior lamellar keratoplasty. This study adds to existing evidence that unilateral corneal disease or surgical trauma can affect the homeostasis of the contralateral cornea. In this study, significant morphological and quantitative changes were observed in the sub-basal nerve plexus of the cornea in the unoperated eyes of patients after refractive surgery. This was accompanied by changes in dry eye parameters and neuromediators in tear fluid. The health-related quality of life (HRQOL) impairment associated with dry eye symptoms (DES) was greater than that caused by the confounding comorbidities. The most affected HRQOL dimensions varied between patients with different severities of DES. The glued amniotic membrane transplantation …","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487010","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}
Jasmin A Branford, Bahram Bodaghi, Lisia Barros Ferreira, Peter J McCluskey, Jennifer E Thorne, Janet M Matthews, International Study Group for Systemic Immunomodulatory Drug Treatment of Non‐Infectious Uveitis, Justine R Smith
Background Non-infectious uveitis is a diverse group of inflammatory conditions that collectively account for substantial blindness worldwide. Expert guidelines and results of clinical trials guide treatment, but real-world clinical care is impacted by additional factors. In 2023, an international group of uveitis-specialised ophthalmologists formed the International Study Group for Systemic Immunomodulatory Drug Treatment of Non-Infectious Uveitis to report current practice. Methods 221 study group members from 53 countries completed a 30-item questionnaire on their management of non-infectious uveitis including: indications for and investigations prior to initiating systemic immunomodulatory drugs, use of conventional and biological drugs, and follow-up of treated patients. Results Major indications to initiate systemic immunomodulatory drugs were: uveitis not controlled with oral prednis(ol)one (n=208, 94.1%), specific uveitis diagnosis (n=197, 89.1%), and patient intolerance of oral prednis(ol)one (n=186, 84.2%). All members (n=221, 100%) performed pretreatment screens including: blood chemistry (n=217, 98.2%), blood examination (n=207, 93.7%), and Quantiferon assay (n=196, 88.7%). Eight conventional and 14 biological drugs were prescribed: methotrexate was the preferred conventional drug overall (n=126, 57.0%) and for 9 of 11 uveitides, and adalimumab was the preferred biological drug overall (n=216, 97.7%) and for 11 of 11 uveitides. When drugs were combined, methotrexate plus adalimumab was most popular (n=158 of 188 members, 84.0%). Patients with inactive uveitis were typically evaluated and screened for drug toxicity every 6–12 weeks (n=161, 72.9%, and 165, 74.7%, respectively). Conclusion Our report describes practice patterns of a large international group of uveitis specialists treating non-infectious uveitis with systemic immunomodulatory drugs. All data relevant to the study are included in the article or uploaded as supplementary information.
{"title":"Use of immunomodulatory treatment for non-infectious uveitis: an International Ocular Inflammation Society report of real-world practice","authors":"Jasmin A Branford, Bahram Bodaghi, Lisia Barros Ferreira, Peter J McCluskey, Jennifer E Thorne, Janet M Matthews, International Study Group for Systemic Immunomodulatory Drug Treatment of Non‐Infectious Uveitis, Justine R Smith","doi":"10.1136/bjo-2024-326239","DOIUrl":"https://doi.org/10.1136/bjo-2024-326239","url":null,"abstract":"Background Non-infectious uveitis is a diverse group of inflammatory conditions that collectively account for substantial blindness worldwide. Expert guidelines and results of clinical trials guide treatment, but real-world clinical care is impacted by additional factors. In 2023, an international group of uveitis-specialised ophthalmologists formed the International Study Group for Systemic Immunomodulatory Drug Treatment of Non-Infectious Uveitis to report current practice. Methods 221 study group members from 53 countries completed a 30-item questionnaire on their management of non-infectious uveitis including: indications for and investigations prior to initiating systemic immunomodulatory drugs, use of conventional and biological drugs, and follow-up of treated patients. Results Major indications to initiate systemic immunomodulatory drugs were: uveitis not controlled with oral prednis(ol)one (n=208, 94.1%), specific uveitis diagnosis (n=197, 89.1%), and patient intolerance of oral prednis(ol)one (n=186, 84.2%). All members (n=221, 100%) performed pretreatment screens including: blood chemistry (n=217, 98.2%), blood examination (n=207, 93.7%), and Quantiferon assay (n=196, 88.7%). Eight conventional and 14 biological drugs were prescribed: methotrexate was the preferred conventional drug overall (n=126, 57.0%) and for 9 of 11 uveitides, and adalimumab was the preferred biological drug overall (n=216, 97.7%) and for 11 of 11 uveitides. When drugs were combined, methotrexate plus adalimumab was most popular (n=158 of 188 members, 84.0%). Patients with inactive uveitis were typically evaluated and screened for drug toxicity every 6–12 weeks (n=161, 72.9%, and 165, 74.7%, respectively). Conclusion Our report describes practice patterns of a large international group of uveitis specialists treating non-infectious uveitis with systemic immunomodulatory drugs. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"111 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541193","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}
Jo-Hsuan Wu, Sasan Moghimi, Takashi Nishida, Mohsen Adelpour, Alireza Kamalipour, Gopikasree Gunasegaran, Linda M Zangwill, Robert N Weinreb
Background/aims: To examine longitudinal optical coherence tomography angiography (OCTA) changes in macula and optic nerve head (ONH) in healthy, glaucoma suspect (GS) and primary open-angle glaucoma (POAG) eyes.
Methods: Healthy, GS and POAG eyes from Diagnostic Innovations in Glaucoma Study with ≥2 years follow-up and four visits of macular/ONH OCTA imaging were included. Rates of macular wiVD (whole-image vessel density) and ONH wiCD (whole-image capillary density) changes were calculated for each diagnosis group using join mixed-effect modelling. Differences in wiVD/wiCD change rates across diagnoses were examined through pairwise comparison. Relationships of baseline 24-2 visual field (VF) mean deviation (MD) with wiVD/wiCD change rates were evaluated for POAG eyes.
Results: There were 36, 57 and 79 eyes (25, 38 and 50 subjects) in healthy, GS and POAG groups, respectively. Rates of wiVD (range:-0.72 to -0.92 %/year) and wiCD (range:-0.28 to -0.66 %/year) loss were different from zero in all groups (p<0.05). The rates of wiCD loss differed across all diagnosis groups (p<0.001), while wiVD change rates did not increase when comparing healthy to GS eyes (p=0.167). Baseline VF MD showed a significant but modest correlation with the rates of both wiVD and wiCD loss (p<0.05), and the correlation with wiCD change rate was slightly stronger (R2=0.27 vs 0.16).
Conclusions: In glaucoma, there is earlier microvasculature loss in the ONH than in the macula. Moreover, ONH VD loss shows a slightly stronger association with baseline VF than macular VD. Observing ONH VD loss with OCTA may help to monitor early glaucoma, which should be confirmed by future larger studies.
{"title":"Longitudinal OCTA vessel density loss in macula and optic nerve head in healthy, glaucoma suspect and established glaucoma eyes.","authors":"Jo-Hsuan Wu, Sasan Moghimi, Takashi Nishida, Mohsen Adelpour, Alireza Kamalipour, Gopikasree Gunasegaran, Linda M Zangwill, Robert N Weinreb","doi":"10.1136/bjo-2024-325746","DOIUrl":"https://doi.org/10.1136/bjo-2024-325746","url":null,"abstract":"<p><strong>Background/aims: </strong>To examine longitudinal optical coherence tomography angiography (OCTA) changes in macula and optic nerve head (ONH) in healthy, glaucoma suspect (GS) and primary open-angle glaucoma (POAG) eyes.</p><p><strong>Methods: </strong>Healthy, GS and POAG eyes from Diagnostic Innovations in Glaucoma Study with ≥2 years follow-up and four visits of macular/ONH OCTA imaging were included. Rates of macular wiVD (whole-image vessel density) and ONH wiCD (whole-image capillary density) changes were calculated for each diagnosis group using join mixed-effect modelling. Differences in wiVD/wiCD change rates across diagnoses were examined through pairwise comparison. Relationships of baseline 24-2 visual field (VF) mean deviation (MD) with wiVD/wiCD change rates were evaluated for POAG eyes.</p><p><strong>Results: </strong>There were 36, 57 and 79 eyes (25, 38 and 50 subjects) in healthy, GS and POAG groups, respectively. Rates of wiVD (range:-0.72 to -0.92 %/year) and wiCD (range:-0.28 to -0.66 %/year) loss were different from zero in all groups (p<0.05). The rates of wiCD loss differed across all diagnosis groups (p<0.001), while wiVD change rates did not increase when comparing healthy to GS eyes (p=0.167). Baseline VF MD showed a significant but modest correlation with the rates of both wiVD and wiCD loss (p<0.05), and the correlation with wiCD change rate was slightly stronger (R<sup>2</sup>=0.27 vs 0.16).</p><p><strong>Conclusions: </strong>In glaucoma, there is earlier microvasculature loss in the ONH than in the macula. Moreover, ONH VD loss shows a slightly stronger association with baseline VF than macular VD. Observing ONH VD loss with OCTA may help to monitor early glaucoma, which should be confirmed by future larger studies.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521058","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}
Shaminie Shanmugaranjan, Cathy Hopkinson, Lewis Downward, Daniel F P Larkin
Aims To investigate the impact of surgeon learning on endothelial keratoplasty (EK) procedure outcomes. Methods A prospective nationwide registry study of EK grafts in patients aged at least 21 years with Fuchs endothelial corneal dystrophy or pseudophakic bullous keratopathy undergoing a first EK procedure in that eye between 2005 and 2020. EK procedures were either Descemet Stripping Endothelial Keratoplasty (DSEK) or Descemet Membrane Endothelial Keratoplasty (DMEK). Primary outcome was transplant survival at 2 years. Secondary outcomes at 1-year post-transplant were (1) best-corrected visual acuity, (2) requirement for repeat air injection procedures to treat graft detachment and (3) iatrogenic primary graft failure. Results Following analysis of 11 516 EK transplants, significant impact of surgeon learning was indicated by (1) the influence of surgeon prior experience in that EK technique, (2) the influence of surgeon prior experience in postoperative management and (3) the time interval from introduction of that EK technique in the United Kingdom to time of surgery. EK grafts reported to have failed within the first 6 months were a significant proportion of all transplant failures. Conclusions Influence of surgeon learning and inexperience in EK of clinical and statistical significance can be quantified and diminishes over time. Equivalent analyses may be feasible for novel procedures in other ophthalmology specialties and surgical training. Training programmes and nationwide advisory networks may be helpful in reducing the duration and impact of surgeon learning curves. Data are available upon reasonable request.
目的 研究外科医生的学习对内皮角膜移植术（EK）疗效的影响。方法 对 2005 年至 2020 年期间首次接受 EK 手术的 21 岁以上福氏内皮角膜营养不良症或假性角膜牛皮癣患者的 EK 移植进行全国性前瞻性登记研究。角膜内皮移植手术包括德斯米剥离内皮角膜成形术（DSEK）或德斯米膜内皮角膜成形术（DMEK）。主要结果是移植后 2 年的存活率。移植后 1 年的次要结果是：(1) 最佳矫正视力；(2) 为治疗移植物脱落而重复注射空气的需求；(3) 原发性移植物失败。结果 对 11 516 例 EK 移植手术进行分析后发现，外科医生的学习对以下几个方面有显著影响：(1) 外科医生之前在该 EK 技术方面的经验的影响；(2) 外科医生之前在术后管理方面的经验的影响；(3) 从该 EK 技术在英国引入到手术时间的时间间隔。据报告，在最初 6 个月内失败的 EK 移植占所有移植失败的很大一部分。结论 外科医生在 EK 方面的学习和经验不足对临床和统计意义的影响是可以量化的，并且会随着时间的推移而减弱。对于其他眼科专业的新型手术和手术培训，也可以进行类似的分析。培训计划和全国性咨询网络可能有助于缩短外科医生学习曲线的持续时间并减少其影响。如有合理要求，可提供相关数据。
{"title":"Influence of surgeon learning on outcomes in new ophthalmic procedures: quantified nationwide evidence in endothelial corneal transplantation","authors":"Shaminie Shanmugaranjan, Cathy Hopkinson, Lewis Downward, Daniel F P Larkin","doi":"10.1136/bjo-2024-325366","DOIUrl":"https://doi.org/10.1136/bjo-2024-325366","url":null,"abstract":"Aims To investigate the impact of surgeon learning on endothelial keratoplasty (EK) procedure outcomes. Methods A prospective nationwide registry study of EK grafts in patients aged at least 21 years with Fuchs endothelial corneal dystrophy or pseudophakic bullous keratopathy undergoing a first EK procedure in that eye between 2005 and 2020. EK procedures were either Descemet Stripping Endothelial Keratoplasty (DSEK) or Descemet Membrane Endothelial Keratoplasty (DMEK). Primary outcome was transplant survival at 2 years. Secondary outcomes at 1-year post-transplant were (1) best-corrected visual acuity, (2) requirement for repeat air injection procedures to treat graft detachment and (3) iatrogenic primary graft failure. Results Following analysis of 11 516 EK transplants, significant impact of surgeon learning was indicated by (1) the influence of surgeon prior experience in that EK technique, (2) the influence of surgeon prior experience in postoperative management and (3) the time interval from introduction of that EK technique in the United Kingdom to time of surgery. EK grafts reported to have failed within the first 6 months were a significant proportion of all transplant failures. Conclusions Influence of surgeon learning and inexperience in EK of clinical and statistical significance can be quantified and diminishes over time. Equivalent analyses may be feasible for novel procedures in other ophthalmology specialties and surgical training. Training programmes and nationwide advisory networks may be helpful in reducing the duration and impact of surgeon learning curves. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"125 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490297","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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