Br J Ophthalmol [JOURNAL]
Sun
200 papers
Identifying patients with poor visual outcomes after primary rhegmatogenous retinal detachment surgery using machine learning.
Sajiki AF, Fukutsu K, Matsumoto A … +3 more , Funatsu R, Miyake M, Akiyama M
Br J Ophthalmol · 2026 Jul · PMID 42399073 · Publisher ↗
AIMS: To develop prediction models for identifying cases with poor visual outcomes after surgery for primary rhegmatogenous retinal detachment (RRD). METHODS: All data were obtained from the Japan-Retinal Detachment Regi...
AIMS: To develop prediction models for identifying cases with poor visual outcomes after surgery for primary rhegmatogenous retinal detachment (RRD). METHODS: All data were obtained from the Japan-Retinal Detachment Registry. Patients with visual acuity (VA) recorded at 6 months after the surgery for primary RRD were included. For identifying the cases with poor VA defined as the logarithm of the minimum angle of resolution VA≥1.0 at 6 months post-surgery, 47 clinical features were selected out of 288 features, then three different machine learning (ML) algorithms (LightGBM, XGBoost and Random Forest) and logistic regression were used to construct models. Discriminative accuracies of the constructed models were compared with the Primary Retinal detachment Outcomes (PRO) score, a previously proposed scoring system for the same purpose. We also estimated the continuous VA using the same three ML algorithms and linear regression model to detect individuals with poor postoperative VA. RESULTS: A total of 2658 patients were included. We observed that all the constructed ML models showed high discriminative accuracies (area under the receiver operating characteristic curve; AUROC: 0.876-0.901). Of the constructed models, the Random Forest model achieved the highest discriminative accuracy (AUROC: 0.901; 95% CI 0.881 to 0.921). The performance of this model appeared to be superior to the PRO score (AUROC: 0.794, 95% CI 0.744 to 0.839). CONCLUSION: ML models predict poor visual prognosis after primary RRD surgery with high discriminative accuracy.
Incidence of bilateral disease and choroidal neovascularisation in punctate inner choroiditis.
Liberman P, Maturi JR, Thorne JE … +3 more , Berkenstock MK, Burkholder BM, Jabs DA
Br J Ophthalmol · 2026 Jul · PMID 42399072 · Publisher ↗
AIMS: To characterise the incidence of bilateral involvement and choroidal neovascularisation (CNV) in punctate inner choroiditis (PIC). METHODS: Retrospective, single-centre case series of 52 patients with PIC evaluated...
AIMS: To characterise the incidence of bilateral involvement and choroidal neovascularisation (CNV) in punctate inner choroiditis (PIC). METHODS: Retrospective, single-centre case series of 52 patients with PIC evaluated at a tertiary referral centre in the USA. Patients meeting Standardization of Uveitis Nomenclature criteria were included. Records were reviewed for laterality, CNV, treatment and visual outcomes. Incidence rates were calculated using person-year and eye-year denominators with staggered entry anchored at PIC diagnosis. Kaplan-Meier methods were used for time-to-event analyses. Time-updated analysis assessed immunosuppression as a risk modifier for active CNV. RESULTS: At diagnosis, 31/52 patients (59.6%) had unilateral disease. During follow-up, 11 developed fellow-eye involvement (0.08/person-year; 95% CI 0.04 to 0.13), with the highest incidence within 5 years of diagnosis (0.20/person-year; 95% CI 0.09 to 0.36). None of the four unilateral patients treated with immunosuppression developed fellow-eye disease while receiving therapy. At diagnosis, CNV was present in 34/73 eyes (46.6%). During follow-up, 20 eyes developed incident CNV (0.06/eye-year; 95% CI 0.04 to 0.10), highest within 5 years of diagnosis (0.14/eye-year; 95% CI 0.08 to 0.22). In time-updated analysis controlling for prior CNV, immunosuppression was associated with reduced odds of active CNV (OR, 0.50; 95% CI 0.27 to 0.93). 10 eyes developed visual acuity worse than 20/40, all associated with CNV; 8 improved to better than 20/40 after anti-vascular endothelial growth factor therapy. CONCLUSION: PIC frequently presents unilaterally but carries risk of bilateral progression. CNV is common at presentation and is a cause of vision loss. Immunosuppression is associated with reduced odds of active CNV.
Reference map of multimodal vision deficits in intermediate age-related macular degeneration: contrast sensitivity and low-contrast visual acuity.
Vingopoulos F, Katz R, Patel NS … +11 more , Garg I, Lu ES, Laíns I, Kasetty M, Silverman RF, Nigalye A, Kim L, Husain D, Miller JW, Vavvas DG, Miller JB
Br J Ophthalmol · 2026 Jul · PMID 42386395 · Publisher ↗
PURPOSE: To provide a reference map of deficits in contrast sensitivity (CS) and low-contrast visual acuity (LCVA) across stages of non-exudative age-related macular degeneration (AMD) and evaluate functional consequence...
PURPOSE: To provide a reference map of deficits in contrast sensitivity (CS) and low-contrast visual acuity (LCVA) across stages of non-exudative age-related macular degeneration (AMD) and evaluate functional consequences of optical coherence tomography structural biomarkers. METHOD: Prospective cross-sectional study of 509 eyes of 358 subjects: 317 dry AMD eyes (99 early, 177 intermediate, 41 advanced), 192 healthy control eyes. Reference limits defined from control eye measures of best-corrected visual acuity (BCVA), quantitative contrast sensitivity function (CSF) measures of LCVA, area under the logarithm CSF (AULCSF), CS at multiple frequencies. Risk scores defined by the sum of structural biomarkers in each eye were associated with visual outcomes across and within AMD stages using multiple linear regression analyses. RESULTS: Compared with controls, AULCSF declined by 2.2 decibels (dB) in early AMD (eAMD), 3.7 dB in intermediate AMD (iAMD) and 8 dB in advanced AMD. Proportions iAMD eyes breaching reference limits: 50% for AULCSF, 36% for BCVA, 39% for LCVA. For eAMD and iAMD, risk scores were significantly correlated with AULCSF (p<0.02) and CS at low frequencies (1-3 cpd, p<0.005) but not BCVA and LCVA (p>0.05). High-risk eyes breached 1-3 cpd reference limits at higher rates (60-68%) than low-risk eyes (24-30%). AULCSF and LCVA deficits were presented on a novel map of multimodal vision loss. CONCLUSION: The functional consequences of AMD structural biomarkers were validated by structure-function analyses. We provide a reference map of multimodal vision deficits in AMD for CS and LCVA that could be useful to follow the progression of vision loss in AMD in routine clinical practice and as a clinical trial endpoint.
Commentary on 'identifying patients with poor visual outcomes after primary rhegmatogenous retinal detachment surgery using machine learning'.
Yorston D
Br J Ophthalmol · 2026 Jul · PMID 42386394 · Publisher ↗
Abstract loading — click title to view on PubMed.
Automated deep learning-based retinoschisis and detachment volume measurement in pathological myopia with posterior scleral contraction.
Chai M, Rong H, Yu D … +9 more , Wang X, Wu D, Pazo EE, Zhang J, Liu Y, Zhou Y, Chen Y, Xue A, Wei R
Br J Ophthalmol · 2026 Jun · PMID 42379831 · Publisher ↗
PURPOSE: This study developed an automated deep learning-based system to quantify retinoschisis and detachment volume (RDV) in pathological myopia (PM) patients undergoing posterior scleral contraction (PSC). METHODS: A...
PURPOSE: This study developed an automated deep learning-based system to quantify retinoschisis and detachment volume (RDV) in pathological myopia (PM) patients undergoing posterior scleral contraction (PSC). METHODS: A prospective study included 51 PM patients (36 PSC-treated and 15 controls). Based on the myopic traction maculopathy staging system classification, PSC-treated patients were divided into retinoschisis (RS, Stage 2, n=21) and retinal detachment (RD, Stages 3-4, n=15), while controls were classified as Stage 1 (n=15). Swept-source optical coherence tomography (OCT) and angiography imaging was used to acquire retinal data, and a Mask R-CNN model was trained to segment and calculate RDV. The primary outcome measures were regional macular recovery rate, defined as the percentage reduction in RDV at 12 months postoperatively. Clinical parameters such as axial length (AL) and best-corrected visual acuity (BCVA) were analysed. RESULT: The model achieved an Intersection over Union of 80.9%. RDV increased with more advanced stages of myopic traction maculopathy (MTM). As MTM stage advanced, RDV distribution shifted from predominantly parafoveal/perifoveal involvement to foveal involvement. Macular RDV increased progressively with MTM stage (control: 0.94 mm, RS: 5.24 mm, RD: 9.50 mm; p<0.001). Postoperative AL decreased significantly and BCVA improved significantly (all p<0.001). Postoperative RDV decreased significantly, achieving macular and foveal recovery rates as 80.90% and 99.50%, respectively. AL reduction demonstrated the strongest correlation with foveal RDV changes (r=0.479, p=0.003). CONCLUSION: The Mask R-CNN-based RDV measurement provides a sensitive 3D biomarker for assessing PSC efficacy and monitoring MTM progression. The system offers objective, high-precision quantification of retinal structural changes, addressing limitations of manual OCT analysis. TRIAL REGISTRATION NUMBER: ChiCTR2200065561.
Bacterial keratitis: a global review of current practices, challenges and innovations.
Koestel E, Yaïci R, Garcin T … +5 more , Dormegny L, Gaucher D, Sauer A, Bouheraoua N, Bourcier T
Br J Ophthalmol · 2026 Jun · PMID 42373310 · Publisher ↗
Bacterial keratitis is a major cause of corneal blindness worldwide, with marked differences in clinical presentation and risk factors across regions. In high-income countries, contact lens use is the leading risk factor...
Bacterial keratitis is a major cause of corneal blindness worldwide, with marked differences in clinical presentation and risk factors across regions. In high-income countries, contact lens use is the leading risk factor, while in low- and middle-income countries, trauma-related infections are more prevalent. Management relies on timely diagnosis and sensitivity-guided topical antibiotic therapy. and species are the most frequently isolated Gram-positive organisms, while is the leading Gram-negative pathogen, especially in contact lens-related cases. Rising antimicrobial resistance complicates care and underscores the importance of performing corneal scraping to ascertain microbiological identification, particularly in severe infections. Fluoroquinolone resistance is increasing among both Gram-positive and Gram-negative isolates. The primary goals of treatment are to eliminate infection, control inflammation, preserve corneal structure and ultimately restore vision. Prompt initiation of antibiotics is essential following microbiological sampling. Conventional diagnostic methods are increasingly complemented by molecular tools such as PCR. Next-generation sequencing offers the potential for unbiased, comprehensive pathogen identification though calibration is needed before clinical implementation. Deep learning-based systems show promise in supporting diagnosis through automated image analysis. Several new antibiotics, primarily fluoroquinolones, may help address multidrug-resistant infections pending clinical validation for ophthalmic use. Primary prevention remains central to reducing disease burden through contact lens hygiene education and simple, low-cost prophylactic measures after corneal trauma.
Real-world integration of an autonomous artificial intelligence system for diabetic retinopathy screening in an endocrinology outpatient clinic.
Gil O, Arad A, Fogel M … +11 more , Vorobichik-Berar O, Katz G, Gurevich R, Tirosh A, Pelz-Sinvani N, Moroz I, Shalem S, Siesky BA, Verticchio Vercellin AC, Harris A, Cohen GY
Br J Ophthalmol · 2026 Jun · PMID 42373309 · Publisher ↗
AIM: To evaluate a real-world clinical integration of an autonomous artificial intelligence (AI) system (AEYE Diagnostic Screening (AEYE-DS), AEYE Health, USA) for diabetic retinopathy (DR) screening using the Topcon NW5...
AIM: To evaluate a real-world clinical integration of an autonomous artificial intelligence (AI) system (AEYE Diagnostic Screening (AEYE-DS), AEYE Health, USA) for diabetic retinopathy (DR) screening using the Topcon NW500 camera (Topcon, Japan) in an endocrinology clinic. METHODS: Adults with type 1 or type 2 diabetes without previously reported DR attending routine endocrinology follow-up were invited to participate. Non-mydriatic, macula-centred fundus photographs were acquired by a novice, non-ophthalmic operator. Images were analysed by AEYE-DS to detect more-than-mild DR (mtmDR). AI-positive results prompted physician counselling and automated referral for internal confirmatory examination. RESULTS: Definitive AEYE-DS results were obtained for 95.7% (245/256) of participants without pharmacological dilation. Seventy-six (29.6%) patients screened positive for mtmDR, of whom 34 (44.7%) completed confirmatory examination at the institution's retina clinic; externally completed follow-up was not captured. Four patients (11.8% of those evaluated) required treatment with intravitreal anti-vascular endothelial growth factor therapy or panretinal photocoagulation. Additional previously unrecognised ocular conditions were identified among several AI-positive patients. Patient satisfaction was high, with >80% reporting the screening was easy to use, time-efficient and recommendable. CONCLUSIONS: In a real-world endocrinology clinic, autonomous AI screening for DR using AEYE-DS integrated with the Topcon NW500 enabled efficient DR screening and achieved high non-mydriatic imageability. A clinically relevant proportion of patients requiring ophthalmic evaluation has been captured. Internal referral for confirmatory testing enabled assessment of downstream outcomes. The findings support scalable, point-of-care autonomous screening and a stepped-referral approach for AI-positive patients.
Maternal smoking during pregnancy: a risk factor for early childhood ophthalmologic conditions.
Ashbell I, Kerman T, Amitai N … +5 more , Marciano D, Hazan I, Imtirat A, Sheiner E, Tsumi E
Br J Ophthalmol · 2026 Jun · PMID 42350100 · Publisher ↗
BACKGROUND/AIMS: To investigate the association between maternal smoking during pregnancy and early childhood ophthalmologic conditions. METHODS: This population-based retrospective cohort study analysed data from infant...
BACKGROUND/AIMS: To investigate the association between maternal smoking during pregnancy and early childhood ophthalmologic conditions. METHODS: This population-based retrospective cohort study analysed data from infants born between 2014 and 2020 within a single healthcare system in Israel. Maternal smoking status was categorised by trimester of exposure and infants were followed for 3 years. Diagnoses were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes and grouped into five categories: strabismus, refractive errors, congenital anomalies, inflammatory and infectious diseases and ocular tumours. Multivariable logistic regression was adjusted for infant gender, ethnicity, socioeconomic status, birth weight, gestational age and maternal age. RESULTS: Among 50 778 infants, 2830 (5.6%) were exposed to maternal smoking during pregnancy. Exposure was associated with increased risk of any ophthalmic condition (adjusted OR 1.15, 95% CI 1.04 to 1.26, p=0.004), strabismus (adjusted OR 1.34, 95% CI 1.06 to 1.69, p=0.013) and inflammatory and infectious diseases (adjusted OR 1.13, 95% CI 1.03 to 1.24, p=0.012). First-trimester exposure showed stronger associations with any ophthalmic condition (adjusted OR 1.16, 95% CI 1.01 to 1.33, p=0.034) and strabismus (adjusted OR 1.52, 95% CI 1.12 to 2.07, p=0.008). Exposure throughout pregnancy showed the strongest associations with any ophthalmic condition (adjusted OR 1.75, 95% CI 1.19 to 2.57, p=0.005), congenital anomalies (adjusted OR 1.85, 95% CI 1.01 to 3.37, p=0.045) and inflammatory/infectious diseases (adjusted OR 1.81, 95% CI 1.24 to 2.63, p=0.002). Refractive errors showed no significant difference. CONCLUSIONS: Maternal smoking during pregnancy, particularly in the first trimester, was associated with increased risk of multiple early childhood ophthalmologic conditions, highlighting the importance of smoking cessation during pregnancy to reduce potential risks to children's visual health.
Clinical characteristics and serovar correlation in adult inclusion conjunctivitis: a cohort study in China.
Wei Y, Xu X, Wang Z … +6 more , Zhang Y, Chen K, Zhou M, Peng B, Lu X, Liang Q
Br J Ophthalmol · 2026 Jun · PMID 42350099 · Publisher ↗
BACKGROUND: Adult inclusion conjunctivitis (AIC) caused by non-trachomatous is often under-recognised due to variable and non-specific clinical features. This study aimed to describe its clinical and laboratory characte...
BACKGROUND: Adult inclusion conjunctivitis (AIC) caused by non-trachomatous is often under-recognised due to variable and non-specific clinical features. This study aimed to describe its clinical and laboratory characteristics, serotype distribution, and their association with clinical presentation and outcome. METHODS: This retrospective cohort study included 22 patients with laboratory-confirmed AIC diagnosed at a tertiary eye centre between February 2023 and January 2026. Clinical signs were graded using a structured conjunctival scoring system. Diagnosis was based on conjunctival cytology, nucleic acid amplification testing and cell culture. genotyping was performed by PCR and sequencing with phylogenetic analysis. Patients were classified into serovar D and non-D groups, and clinical severity scores and time to resolution were compared using the Mann-Whitney U test. RESULTS: Patients presented with subacute or chronic conjunctivitis with variable conjunctival hyperaemia, follicular reaction, papillary hypertrophy and discharge. genotyping revealed a heterogeneous serovar distribution, with serovar D predominating. Overall clinical scores at presentation were higher in patients with non-D serovars than in those with serovar D (p<0.05), while only papillary reaction differed among individual signs. Time to clinical resolution after standard antibiotic therapy varied but did not differ significantly between groups. CONCLUSION: This study provides a clinical and molecular profile of AIC and highlights variability across ompA serotypes. By generating data from a Chinese cohort, it helps address the limited evidence base in this setting and may support improved clinical recognition and future genotype-phenotype research.
Drusen volume and reticular pseudodrusen volume from optical coherence tomography with deep learning as risk factors for progression to late age-related macular degeneration in eyes with reticular pseudodrusen and contralateral macular neovascularisation.
Wu AL, Guo Y, Hormel TT … +5 more , Flaxel CJ, Hwang TS, Huang D, Jia Y, Bailey ST
Br J Ophthalmol · 2026 Jun · PMID 42336620 · Publisher ↗
AIM: To implement a deep learning-based segmentation algorithm to quantify reticular pseudodrusen (RPD) and drusen volumes on optical coherence tomography (OCT) and investigate their association with progression to late...
AIM: To implement a deep learning-based segmentation algorithm to quantify reticular pseudodrusen (RPD) and drusen volumes on optical coherence tomography (OCT) and investigate their association with progression to late age-related macular degeneration (AMD). METHODS: A retrospective analysis included study eyes with RPD and contralateral neovascular AMD using 6×6 mm macular OCT (Solix; Visionix/Optovue, Inc). Automated segmentation quantified RPD and drusen volumes, including large drusen and drusenoid pigment epithelial detachment (PED), and late AMD development was evaluated over 2 years. Associations between baseline volumetric biomarkers and progression were evaluated using Cox proportional hazards models. RESULTS: Fifty-one eyes (mean age 74.9±7.65 years) were included. The median (IQR) baseline RPD volume was 0.018 mm³ (0.004-0.52) and total drusen volume was 0.009 mm³ (0.001-0.064). Over 24.2±1.20 months, late AMD developed in 20 eyes (39.2%). In multivariable Cox regression models adjusted for age, each 0.01 mm³ increase in baseline RPD volume (HR: 1.082; p=0.002) and total drusen volume (HR: 1.080; p<0.001) were associated with progression to late AMD. In an exploratory drusen subtype analysis, progression to late AMD was independently associated with baseline RPD volume, large drusen volume and drusenoid PED volume. CONCLUSION: The deep learning-based volumetric segmentation tool allows OCT-derived automated volume quantification of different types of drusen based on OCT. In eyes with RPD and contralateral neovascular AMD, greater RPD volume and large drusen and/or drusenoid PED volume carried greater risk of developing late AMD in 2 years.
Estimation of high myopia-associated optic neuropathies: the Two-Continent Eye Study.
Jonas JB, Jonas RA, Bikbov MM … +5 more , Kazakbaeva GM, Iakupova EM, Wang YX, Nangia V, Panda-Jonas S
Br J Ophthalmol · 2026 Jun · PMID 42336619 · Publisher ↗
PURPOSE: To estimate probabilities of high myopia-associated glaucomatous/glaucoma-like optic neuropathy (GLON) and non-glaucomatous optic neuropathy (NGON). METHODS: Participants of four population-based investigations...
PURPOSE: To estimate probabilities of high myopia-associated glaucomatous/glaucoma-like optic neuropathy (GLON) and non-glaucomatous optic neuropathy (NGON). METHODS: Participants of four population-based investigations (Beijing Eye Study (n=3316 participants; age: 40+ years), Ural Eye and Medical Study (n=5372; age: 40+ years), Ural Very Old Study (n=586; age: 85+ years), Ural Children Eye Study (n=4328; age: 6+ years), Central India Eye and Medical Study (n=4374; age: 30+ years) underwent medical and ophthalmological examinations. RESULTS: The study population (n=35 167 eyes; 17 996 individuals) was randomly divided (ratio: 1:1) into a development and validation subgroup. In the development subgroup, the GLON prevalence equation was: -20.221+0.359×Axial Length+0.083×Age+0.706×Indian Ethnicity+0.198×Intraocular Pressure (IOP)+0.780×NGON-Presence. The NGON prevalence equation was: -38.136+1.202×Axial Length+0.038×Age-2.745×Indian Ethnicity+0.566×Myopic Macular Degeneration Stage+1.300×GLON Presence. In the validation subgroup, these equations had an area under the receiver operating characteristic curve for GLON prevalence and NGON prevalence of 0.881 and 0.964, respectively. Applying the equations, a non-Indian individual (axial length: 28 mm; IOP: 22 mm Hg) had a GLON probability of 3.5% and 60.2% at the ages of 30 years and 75 years, respectively, and an NGON probability of 3.42% and 16.4%, respectively. With an axial length of 30 mm, GLON probability and NGON probability increased from 6.9% to 75.6% and from 28.2% to 68.4% from age 30 years to 75 years. CONCLUSIONS: The equations offer a rough estimate of optic nerve damage probability at present and at older age, based on axial length, IOP, ethnicity and ocular comorbidity. The calculated probability of GLON and NGON (IOP: 22 mm Hg, age: 75 years) at an axial length of 28 mm was 60.2% and 16.4%, respectively, and 75.6% and 68.4%, respectively, for an axial length of 30 mm.
Microstructural and neural impairment of the ocular surface induced by HER2-targeted ADCs: a prospective longitudinal study with ultrastructural insights.
Yang L, Cui M, Huang S … +5 more , Li X, Li F, Shang Z, Zhao S, Yang R
Br J Ophthalmol · 2026 Jun · PMID 42331364 · Publisher ↗
AIMS: To characterise the clinical and morphological features of ocular surface toxicity induced by human epidermal growth factor receptor 2 (HER2)-targeted antibody-drug conjugates (ADCs) in patients with HER2-positive...
AIMS: To characterise the clinical and morphological features of ocular surface toxicity induced by human epidermal growth factor receptor 2 (HER2)-targeted antibody-drug conjugates (ADCs) in patients with HER2-positive breast cancer, guiding clinical intervention. METHODS: 21 HER2-positive breast cancer patients receiving HER2-ADC therapy were enrolled. Assessments included best corrected visual acuity, the Ocular Surface Disease Index, conjunctival lissamine green staining, tear break-up time, tear meniscus height, Meibomian Gland Score, Strip Meniscometry Tube (SMTube strips), corneal sensitivity (Cochet-Bonnet esthesiometry), anterior segment optical coherence tomography and in vivo confocal microscopy (IVCM) to evaluate morphology, corneal nerve fibre density and length, and endothelial cell density. Transmission electron microscopy (TEM) was performed in selected cases. All parameters were compared from baseline to follow-up. RESULTS: Ocular surface toxicity occurred in 85.7% (18/21) of patients after HER2-ADC therapy, with a mean onset at 28.0±8.4 days. Vortex-like keratopathy progressed from inferior subepithelial microcysts to linear deposits and a vortex pattern. IVCM revealed severe subepithelial nerve fibre fragmentation and loss. TEM revealed epithelial extracellular matrix fibrosis, mitochondrial damage (swelling, disordered cristae, vacuolisation), nuclear alterations (chromatin dispersion, electron-dense deposits) and suspected endocytic vesicles. Lesions appeared dose- and time-dependent and showed partial reversibility. After 12 cycles, corneal structure and transparency showed restoration trends. CONCLUSION: HER2-ADC-induced ocular surface toxicity presents as vision loss, dry eye and selective damage to corneal epithelium (vortex-like keratopathy) and nerves (nerve fibre loss and reduced sensitivity), which is dose- and time-dependent and partially reversible.
Symblepharon Release and Fornix Reconstruction after Ocular Chemical Injury: Outcomes from a Decade-Long Clinical Experience.
Bhambhani V, Vijayaraghavan M, Rajarajan M … +5 more , Srinivasan B, Iyer G, Surya J, Kheirkhah A, Agarwal S
Br J Ophthalmol · 2026 Jun · PMID 42320992 · Publisher ↗
PURPOSE: To evaluate anatomical, visual and cosmetic rehabilitation outcomes of symblepharon release with fornix reconstruction (SR-FR) in eyes with chronic chemical injury and identify factors influencing surgical succe...
PURPOSE: To evaluate anatomical, visual and cosmetic rehabilitation outcomes of symblepharon release with fornix reconstruction (SR-FR) in eyes with chronic chemical injury and identify factors influencing surgical success. METHODS: Retrospective observational study of patients undergoing SR-FR for chemical injury-related symblepharon over 10 years at a tertiary eye care centre. Symblepharon severity, surgical techniques, epithelial healing and demographics were recorded. Anatomical (success, partial success and failure), visual rehabilitation and cosmetic rehabilitation outcomes were analysed. Multivariate ordinal logistic regression identified factors associated with anatomical outcome. RESULTS: The study involved 125 fornices in 118 patients. Median age at injury was 7 years (IQR 4-19) and at SR-FR 12 years (IQR 5-24), with a median follow-up of 15 months (IQR 8-36). Successful anatomical outcome was achieved in 61.6% after the first procedure, increasing to 84.8% after final reconstruction. Severe symblepharon was associated with lower success rates and greater need for repeat attempts (p=0.027). On multivariate analysis, symblepharon grade was an independent predictor of anatomical outcome (p=0.005), while epithelial healing was associated with improved outcome (p=0.046); delayed epithelial healing was independently associated with poorer outcome (p=0.011); age, gender, chemical type, mitomycin-C use and fornix-forming sutures were not significant. Visual improvement was independent of anatomical success and primarily limited by ocular comorbidities. CONCLUSIONS: SR-FR is an effective approach for anatomical restoration. Symblepharon severity is an independent predictor of outcome, while delayed epithelialisation is a clinically relevant early postoperative indicator of poorer outcomes. Visual recovery is largely determined by associated ocular comorbidities.
Repeated low-level red light therapy for pathologic myopia: a case series of two adult patients.
Zhang J, Zou Y, Zhang H … +2 more , Zou H, Xu Y
Br J Ophthalmol · 2026 Jun · PMID 42320991 · Publisher ↗
Pathologic myopia (PM) is a leading, traditionally irreversible cause of vision loss primarily managed through observation. This pilot case series explores repeated low-level red light (RLRL) therapy for PM. Two adult pa...
Pathologic myopia (PM) is a leading, traditionally irreversible cause of vision loss primarily managed through observation. This pilot case series explores repeated low-level red light (RLRL) therapy for PM. Two adult patients underwent twice-daily home-based RLRL sessions for 6 months. Preliminary observations revealed functional improvement in visual acuity for one patient, while the other demonstrated modest anatomical recovery, including reduced macular retinoschisis and slightly decreased axial length. These hypothesis-generating findings suggest RLRL might offer structural and functional benefits. However, rigorous future randomised controlled trials remain essential to validate its clinical efficacy.
Real-World Insights on Switching Aflibercept Dosage for Enhanced Outcomes in Retinal Vein Occlusion (RISE-RVO): visual, anatomical and durability outcomes.
Nguyen CT, Lassen RKB, Mæng MO … +6 more , Lee C, Subhi Y, Vorum H, Wykoff CC, Ørskov M, Cehofski LJ
Br J Ophthalmol · 2026 Jun · PMID 42309665 · Publisher ↗
BACKGROUND/AIMS: Evaluation of durability outcomes after switching to aflibercept 8 mg for macular oedema in retinal vein occlusion (RVO). METHODS: We evaluated eyes with branch retinal vein occlusion (BRVO) or central r...
BACKGROUND/AIMS: Evaluation of durability outcomes after switching to aflibercept 8 mg for macular oedema in retinal vein occlusion (RVO). METHODS: We evaluated eyes with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), switching from other anti-vascular endothelial growth factor treatments to off-label aflibercept 8 mg under an observe-and-plan regimen. Eyes receiving ongoing treatment with ≥10 prior injections were eligible. Treatment discontinuation during the 12-month follow-up period resulted in exclusion. All data were obtained through the review of medical records. RESULTS: The overall cohort of eyes with RVO (n=156) achieved a mean interval gain of +1.6 weeks at 12 months (p<0.0001). The proportion of eyes treated at ≤6-week intervals decreased from 37.8% at switch to 17.9% at 12-month follow-up (p<0.0001) while the proportion on intervals ≥9 weeks increased from 37.8% at switch to 60.3% (p<0.0001). The CRVO subgroup (n=65) achieved a mean increase in interval length at 12 months of +2.0 weeks (p<0.0001) and +3.0 weeks in the case of a dry macula at switch (p<0.0001). The BRVO subgroup (n=91) achieved an overall increase in interval length of +1.3 weeks (p<0.0001) and +2.3 weeks for eyes with a dry macula at switch (p<0.0001). The central retinal thickness decreased from 262.8±79.4 µm to 244.6±59.5 µm (p=0.0012) while best recorded visual acuity remained unchanged at 68.2 Early Treatment Diabetic Retinopathy Study letters at 12 months. CONCLUSION: Switching to aflibercept 8 mg substantially reduced the proportion of eyes on short intervals without compromising visual outcomes.
Can switching between different types of myopia control spectacles enhance effectiveness? Findings from a real-world study.
Zhang J, Pan Q, Jin L … +5 more , Zhang S, Morgan I, Luo L, Zeng Y, Han X
Br J Ophthalmol · 2026 Jun · PMID 42303290 · Publisher ↗
AIMS: To investigate the effect of switching to a different type of myopia control spectacles on myopia progression. METHODS: This retrospective matched-cohort study involved 1012 children or adolescents who were prescri...
AIMS: To investigate the effect of switching to a different type of myopia control spectacles on myopia progression. METHODS: This retrospective matched-cohort study involved 1012 children or adolescents who were prescribed myopia control spectacles. Participants were divided into two groups: the change-of-type group (n=253), who switched to a different spectacle type, and the type-maintenance group (n=759), who retained the same type, using 1:3 propensity score matching. The primary outcome was the annual rate of spherical equivalent refraction progression (D/year) compared between and within groups before and after the switch. RESULTS: The initial prescription of myopia control spectacles occurred at a mean age of 9.46±2.11 years. Subsequent prescription (renewing the same type or switching to a new type) was provided at a mean age of 10.63±2.16 years. Before switching spectacles, the change-of-type group exhibited a significantly faster myopia progression rate than the type-maintenance group (-0.66±0.40 D/year vs -0.37±0.49 D/year; p<0.001). After switching, the progression rate slowed in the change-of-type group (mean reduction 0.18 D/year, p<0.001), narrowing the intergroup difference from 0.30 D/year to 0.08 D/year (-0.48±0.61 vs -0.40±0.50 D/year; p<0.001). However, the improved effect in the change-of-type group was not sustained, with myopia progression accelerating again with prolonged use (early vs late phase, -0.33 vs -0.53 D/year, p=0.024). CONCLUSIONS: Switching to a different type of myopia control spectacle may help slow myopia progression for children exhibiting suboptimal response to their initial spectacles. However, this beneficial effect tends to wane over time with prolonged wear.
Intereye differences in myopic macular degeneration, intraocular pressure and axial length: the Two-Continent Eye Study.
Jonas JB, Jonas RA, Bikbov MM … +8 more , Kazakbaeva GM, Iakupova EM, Milea D, Bron AM, Lamirel C, Nangia V, Wang YX, Panda-Jonas S
Br J Ophthalmol · 2026 Jun · PMID 42303289 · Publisher ↗
PURPOSE: To assess associations of myopic macular degeneration (MMD) with intraocular pressure (IOP). METHODS: The project included the population-based Beijing Eye Study (n=3335 participants; age: 40+ years), Ural Eye a...
PURPOSE: To assess associations of myopic macular degeneration (MMD) with intraocular pressure (IOP). METHODS: The project included the population-based Beijing Eye Study (n=3335 participants; age: 40+ years), Ural Eye and Medical Study (n=5589; age: 40+ years), Ural Very Old Study (n=566; age: 85+ years) and Ural Children Eye Study (n=4325; age: 6+ years) and Central India Eye and Medical Study (n=4514; age: 30+ years). MMD was defined according to the Meta-analysis for Pathologic Myopia Study Group. RESULTS: The study population included 35 778 eyes (18 328 individuals) (age: 46.9±23.1 years; range: 6-100 years) (axial length: 23.2±1.0 mm; range: 18.08-34.20 mm). Longer axial length was associated with higher IOP (ß:0.03; p<0.001) with adjusting for age (ß:0.01; p<0.001), sex (ß:-0.19; p=0.006) and MMD-stage (ß:0.47; p<0.001). Intereye axial length difference correlated (r=0.11) with higher intereye difference in IOP (ß: 0.03; p<0.001) after adjusting for age (ß: 0.06; p<0.001), sex (ß: -0.07; p<0.001) and higher intereye difference in MMD-stage (ß: 0.32; p<0.001). Higher intereye IOP difference correlated (r=0.03) with higher intereye axial length difference (ß: 0.03; p<0.001) after adjusting for age (ß: -0.15; p<0.001), but not with intereye difference in MMD-stage (p=0.90). Higher intereye difference in MMD-stage was associated (r=0.10) only with higher intereye axial length difference (ß: 0.32; p<0.001) and sex (ß: 0.01; p=0.04). Higher intereye difference in MMD prevalence (defined as MMD-stage 3+) correlated with intereye axial length difference (ß: 0.24; p<0.001) and female sex (ß: 0.02; p=0.006) but not with intereye IOP difference (p=0.14). CONCLUSIONS: Although IOP was associated with longer axial length, MMD stage and MMD prevalence were not significantly related to IOP, neither in an interindividual comparison nor in an intraindividual intereye comparison. The data point against a therapeutic IOP reduction as a measure to reduce development or progression of MMD.
Choroidal vascular hyperpermeability and submacular haemorrhage in polypoidal choroidal vasculopathy: a multi-field ICGA analysis.
Zhang Y, Pu J, Zhuang X … +7 more , Hao X, Chen X, He Y, Zhang G, Li M, Ji Y, Wen F
Br J Ophthalmol · 2026 Jun · PMID 42303288 · Publisher ↗
PURPOSE: To investigate the association between choroidal vascular hyperpermeability (CVH) and the occurrence of submacular haemorrhage (SMH) in polypoidal choroidal vasculopathy (PCV). METHODS: This retrospective, cross...
PURPOSE: To investigate the association between choroidal vascular hyperpermeability (CVH) and the occurrence of submacular haemorrhage (SMH) in polypoidal choroidal vasculopathy (PCV). METHODS: This retrospective, cross-sectional study included 189 eyes of 159 patients with treatment-naïve PCV. Eyes were categorised into haemorrhage (n=84) and non-haemorrhage (n=105) groups based on the extent of subretinal or subretinal pigment epithelium haemorrhage. Nine-field indocyanine green angiography (ICGA) was performed to evaluate the presence, number, topographic distribution and area of CVH. Logistic regression and correlation analysis were performed to identify factors associated with SMH. RESULTS: The cohort comprised predominantly male patients (67.3%), with a mean age of 65.4±7.6 years. The haemorrhage group showed significantly lower CVH prevalence (32.1% vs 68.6%; p<0.001) and median CVH count (0 vs 1; p<0.001) compared with the non-haemorrhage group. Multivariate model demonstrated that both the presence (p<0.001) and higher count (p=0.004) of CVH were independently associated with a reduced likelihood of SMH. Topographically, this negative association was most pronounced for CVH located in the posterior pole, central nasal and central superior quadrants (all p<0.05). A weak but significant inverse correlation was also observed between the total area of CVH and the area of haemorrhage (Spearman's r=-0.248). CONCLUSIONS: The presence and counts of CVH are inversely associated with the occurrence of SMH in PCV, suggesting CVH may serve as a 'pressure-relief window' to dissipate suddenly elevated choroidal vascular pressure which predisposes to vessel rupture.
DeepAdapter: a generalisable algorithm integrating self-supervised learning and unsupervised domain adaptation for robust retinopathy of prematurity screening.
Zhao J, Li L, Lin Z … +12 more , Luo M, Yun D, Wen J, Liu L, Li J, Xu F, Xie S, Wei M, Liu B, Liu Z, Lin D, Lin H
Br J Ophthalmol · 2026 Jun · PMID 42285743 · Publisher ↗
AIMS: To develop and validate DeepAdapter, a novel deep learning algorithm that integrates self-supervised learning (SSL) and unsupervised domain adaptation (UDA) to enhance model generalisability for retinopathy of prem...
AIMS: To develop and validate DeepAdapter, a novel deep learning algorithm that integrates self-supervised learning (SSL) and unsupervised domain adaptation (UDA) to enhance model generalisability for retinopathy of prematurity (ROP) screening. METHODS: DeepAdapter was developed in two stages. First, SSL was applied to 500 000 unlabelled infantile colour fundus photographs (CFPs) retrospectively collected from four Chinese clinical centres to learn general fundus representations. Second, a much smaller labelled dataset of Normal and ROP CFPs was constructed, and a UDA module was incorporated to mitigate domain shift, defined as distribution differences between training and deployment datasets that may impair model performance. Correlation Alignment (CORAL) distance was employed to quantify these domain shifts. External validation was performed using data from an independent clinical centre and two public multiethnic datasets. RESULTS: A total of 500 000 non-overlapping unlabelled CFPs and 39 456 labelled CFPs were included. Compared with the supervised method, DeepAdapter decreased CORAL distance from 0.297 to 3.550×10. Both algorithms achieved high internal accuracy (0.989) in ROP prediction, but DeepAdapter significantly outperformed the supervised method on external testing (accuracy: 0.828 (95% CI 0.823 to 0.833) vs 0.739 (95% CI 0.733 to 0.745), p <0.001) and on the public cross-ethnicity dataset (accuracy: 0.839 (95% CI 0.818 to 0.859) vs 0.813 (95% CI 0.791 to 0.835), p=0.014). A web-based system integrating quality control and ROP diagnosis was developed for large-scale, multicentre clinical screening. CONCLUSIONS: DeepAdapter effectively mitigated domain shift and significantly improved model generalisability for ROP screening, providing a valuable reference for developing generalisable models in other medical specialties.
Development of diagnostic criteria for Behçet's uveitis in a Chinese population.
Yang P, Zhang W, Chen L … +22 more , Zhang P, Weng W, Wang Y, Duan Y, Su G, Huang Z, Zhang X, Ling D, Wang J, Li K, Wang Y, Xia L, Lu A, Hu R, Wang J, Liu R, Deng Y, Zhang Y, Lai Y, Ye Z, Wang C, Tan H
Br J Ophthalmol · 2026 Jun · PMID 42270295 · Publisher ↗
BACKGROUND: To develop and validate a novel set of ocular-centric diagnostic criteria for Behçet's uveitis (BU). METHODS: A case-control study was designed to develop the BU-specific diagnostic criteria (BU-SDC). The Int...
BACKGROUND: To develop and validate a novel set of ocular-centric diagnostic criteria for Behçet's uveitis (BU). METHODS: A case-control study was designed to develop the BU-specific diagnostic criteria (BU-SDC). The International Criteria for Behçet's Disease were adopted as the reference standard for diagnostic performance evaluation. RESULTS: The ocular findings of BU-SDC were weighted as two points for vitreous cells or haze and retinal vasculitis identified by fluorescein fundus angiography, respectively, and one point for anterior cell-flare dissociation, sterile hypopyon, diffuse retinal atrophy, optic nerve atrophy, superficial retinal infiltrates, retinal haemorrhages, retinal vascular sheathing and retinal ghost vessels, respectively. The systemic features, including recurrent oral ulceration, multiform skin lesions and genital ulceration were weighted as 4 points, 3 points and 2 points, respectively. Primary assessment was based on ocular features alone. An ocular score ≥5 supported a BU diagnosis in patients without signs of granulomatous uveitis or evidence of sarcoidosis or syphilis. For patients with ocular score <5 but high clinical suspicion (the presence of one or more characteristic ocular signs, including vitreous cells or haze, retinal vasculitis identified by fluorescein fundus angiography, superficial retinal infiltrates or retinal vascular sheathing), a secondary assessment incorporating systemic variables was applied, and a combined score ≥5 supported diagnosis. Validation in the independent cohort showed that the area under the receiver operating characteristic curve for BU-SDC (0.954) significantly outperformed the International Study Group criteria (0.911; p<0.01) and the Standardization of Uveitis Nomenclature (0.881; p<0.01) criteria. CONCLUSIONS: The BU-SDC provides a validated ocular-centric diagnostic framework for BU, prioritising ocular signs while retaining flexibility through selective systemic integration.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe