BACKGROUND/AIMS: To evaluate the effects of intraocular pressure (IOP)-lowering agents in highly myopic eyes. METHODS: Highly myopic patients with axial length (AL) data for longer than 5 years were included. The changes...BACKGROUND/AIMS: To evaluate the effects of intraocular pressure (IOP)-lowering agents in highly myopic eyes. METHODS: Highly myopic patients with axial length (AL) data for longer than 5 years were included. The changes in IOP, AL and myopic macular complications during the study period were compared between the eyes treated with IOP-lowering agents (treatment group) and those never treated (control group). RESULTS: The treatment (30 eyes of 30 patients) and control (90 eyes of 90 patients) groups had comparable baseline characteristics except for IOP, which was significantly higher in the treatment group (p=0.020). During the study period, the treatment group showed a greater mean percentage decrease in IOP per year compared with the control group (-2.13±2.51% /year vs+0.30 ± 2.31% /year; p<0.001). The mean change in AL per year was +0.032 ± 0.050 mm/year in the treatment group and +0.058 ± 0.054 mm/year in the control group (p=0.022), and the difference was more pronounced in eyes with posterior staphyloma or without dome-shaped macula. The progression of myopic macular degeneration (MMD), myopic retinoschisis and myopic choroidal neovascularisation during the study period was comparable between groups, but the increase in MMD category was significantly less frequent in the treatment group (3.3% vs 20.0%; p=0.040). In the multivariate analysis, use of IOP-lowering agents was associated with both decreased axial elongation and lower likelihood of MMD category increase. CONCLUSION: IOP-lowering agents may be effective in alleviating axial elongation and progression of myopic maculopathy in highly myopic eyes.
Liu Y, Huang J, Ao M
… +30 more, Huang Y, Ma X, Han Q, Sun D, Zhong J, Qiu Q, Peng H, Wang Z, Ye J, Ma Z, Hao Y, Hu Y, Chang Q, Lu H, Li X, Liang J, Li S, Li J, Yu X, Yang L, Bi C, Li B, Zhang F, Wu R, Jin X, Zhou G, Liao M, Lei Y, Han H, Yan H
AIMS: To evaluate the efficacy of intravitreal conbercept (IVC) combined with pars-plana vitrectomy (PPV) for severe, non-clearing vitreous haemorrhage (VH) caused by proliferative diabetic retinopathy (PDR) in real-worl...AIMS: To evaluate the efficacy of intravitreal conbercept (IVC) combined with pars-plana vitrectomy (PPV) for severe, non-clearing vitreous haemorrhage (VH) caused by proliferative diabetic retinopathy (PDR) in real-world practice. METHODS: This prospective, observational, multicentre, cohort study enrolled 523 patients with VH due to PDR at 26 hospitals from August 2022 to June 2024. Patients were treated with preoperative IVC (3-7 days prior to PPV), intraoperative IVC (at completion of PPV) and PPV alone as control. The primary outcome was the incidence of early (7-30 days) postoperative VH (POVH). Secondary outcomes included late POVH (30-180 days), postoperative best-corrected visual acuity (BCVA) and distribution of POVH severity. RESULTS: Of 425 participants (425 eyes) finally enrolled, 406 completed 30-day-visit, and 341 completed 180-day-visit. The incidence of early POVH was 24.0% (36 of 150) in preoperative IVC versus 23.2% (33 of 142) intraoperative IVC compared with 37.6% (50 of 133) in control (p=0.0160, 0.0122). The incidence of late POVH was 11.9% (16 of 134) in preoperative IVC versus 17.5% (20 of 114) intraoperative IVC versus 17.8% (19 of 107) in control (p=0.4109, 0.4661). The early POVH was less severe in preoperative and intraoperative IVC cohorts compared with control (p=0.0067, 0.0304), while the severity of late POVH was comparable (p=0.4860, 0.8353). Mean postoperative BCVA was all improved but showed no significant intergroup differences (p>0.05). CONCLUSIONS: This study, with the largest participants to date, demonstrates that IVC administered preoperatively or intraoperatively effectively reduces early POVH incidence, rather than late POVH. Preoperative IVC may be preferable for patients with more severe baseline disease characteristics.
BACKGROUND/AIMS: Deep learning algorithms have shown promise for glaucoma detection using retinal imaging. The Northern Finland Birth Cohort Eye Study is a randomised prospective cohort designed to evaluate the efficacy...BACKGROUND/AIMS: Deep learning algorithms have shown promise for glaucoma detection using retinal imaging. The Northern Finland Birth Cohort Eye Study is a randomised prospective cohort designed to evaluate the efficacy and cost-effectiveness of glaucoma screening in a middle-aged population. This study assessed the performance and generalisability of G-RISK, a deep learning model for glaucoma screening from fundus images, in individuals aged 45-49 years with low glaucoma prevalence (1.1%). METHODS: Four screening scenarios were evaluated: detection of (1) glaucoma eyes, (2) glaucoma patients, (3) glaucoma and glaucoma suspect eyes and (4) glaucoma and glaucoma suspect patients. Performance across four photographic modalities was assessed using the area under the receiver operating characteristic curve (AUC), the precision-recall AUC (PR-AUC), and sensitivity at 95% specificity. RESULTS: G-RISK achieved its highest performance when screening for glaucoma eyes using colour fundus photographs, with an AUC of 0.83 (95% CI 0.75 to 0.90), PR-AUC of 0.16 (95% CI 0.05 to 0.28) and sensitivity at 95% specificity of 0.43 (95% CI 0.28 to 0.59). Furthermore, discrimination remained consistent across other modalities (AUC 0.75-0.78). Performance was higher for confirmed glaucoma than combined glaucoma and glaucoma suspect cases (AUC 0.83 vs 0.67). CONCLUSIONS: G-RISK achieved the best results on colour fundus images, while maintaining discrimination across other imaging modalities. Screening metrics were constrained by the relatively young age and low glaucoma prevalence of the cohort. The reduced performance observed when including glaucoma suspects may relate to variability and uncertainty in their clinical definition.
BACKGROUND: Glaucoma, a leading cause of irreversible blindness worldwide, affects over 60 million people globally and 700 000 in the UK. Elevated intraocular pressure (IOP) is the only modifiable risk factor for disease...BACKGROUND: Glaucoma, a leading cause of irreversible blindness worldwide, affects over 60 million people globally and 700 000 in the UK. Elevated intraocular pressure (IOP) is the only modifiable risk factor for disease progression. Micropulse trans-scleral cyclophotocoagulation (MP-TSCPC) offers a promising alternative to conventional treatments by reducing IOP with minimal complications. Although MP-TSCPC is hypothesised to lower IOP by decreasing aqueous humour production and altering aqueous outflow, the precise mechanisms remain poorly understood. AIMS: This study aimed to evaluate the effects of MP-TSCPC on aqueous humour dynamics in patients with open-angle glaucoma and ocular hypertension (OHT), focusing on IOP, aqueous humour production and outflow pathways 6 months post treatment. RESULTS: Of the 31 patients undergoing MP-TSCPC, 61% were men, of which 71% were of black ethnicity, with 28 patients completing the 6-month follow-up. A significant 10% reduction in mean IOP (25.08±5.06 mm Hg to 22.56±4.89 mm Hg, p=0.005) and a 26.08% reduction in aqueous humour production (from 2.34±0.64 to 1.74±0.4 µL/min, p=0.0001) were observed. There were no statistically significant changes in tonographic outflow facility or uveoscleral outflow. Treatment was well-tolerated, with few mild adverse events reported. CONCLUSION: This study demonstrates that MP-TSCPC reduces IOP primarily through decreased aqueous humour production, with no discernible impact on outflow pathways. These findings refine the understanding of MP-TSCPC's mechanism of action, highlighting its potential as a safe and effective treatment for glaucoma and OHT. Future studies should explore ways to enhance efficacy and long-term outcomes.
AIMS: To quantify the regional ischaemic index (ISI) in eyes with retinal vein occlusion (RVO) and to determine its correlation with macular oedema (ME). METHODS: In this retrospective study, ultra-widefield fluorescein...AIMS: To quantify the regional ischaemic index (ISI) in eyes with retinal vein occlusion (RVO) and to determine its correlation with macular oedema (ME). METHODS: In this retrospective study, ultra-widefield fluorescein angiography was performed in 46 eyes with RVO. The retinal ISI was calculated for the perimacular area (PMA), near-peripheral area (NPA), mid-peripheral area (MPA), and far-peripheral area (FPA), each further divided into superior-inferior and nasal-temporal segments. Central macular thickness (CMT) was measured with spectral-domain optical coherence tomography. Associations between regional ISI and CMT were analysed using Spearman's correlation and linear regression. RESULTS: 46 eyes of 46 RVO patients were enrolled. Mean CMT was 453.73±301.48 µm. ISI in the S-NPA (superior NPA) strongly correlated with that in the I-NPA (inferior NPA) (r=0.53, p<0.001); a moderate correlation was observed between S-MPA (superior MPA) and I-MPA (inferior MPA) (r=0.32, p=0.03). Linear regression showed that S-NPA ISI predicted I-NPA ISI (B=0.54, p<0.001) and S-MPA ISI predicted I-MPA ISI (B=0.42, p=0.004). Among regions, PMA (r=0.31, p=0.04), I-NPA (r=0.35, p=0.02) and I-FPA (inferior FPA) (r=0.33, p=0.048) significantly correlated with CMT. Linear regression identified that PMA ISI (B=0.32, p=0.03) and I-NPA ISI (B=0.42, p=0.007) could independently predict increased CMT. CONCLUSIONS: ME severity in RVO was correlated with PMA and I-NPA ischaemia. Moreover, these specific regional ISI values could independently predict CMT, highlighting potential targets for personalised therapy.
Ntonti P, Coleman AL, Wilson MR
… +12 more, Harris A, Papakonstantinou E, Giannoulis DA, Kilintzis V, Haidich AB, Yu F, Pappas T, Anastasopoulos E, Vagiakis I, Raptou A, Tzoanou G, Topouzis F
AIMS: To determine baseline risk factors of incident open-angle glaucoma (OAG) in an elderly white population. METHODS: Prospective-longitudinal population-based study. 12 years following baseline examinations, subjects...AIMS: To determine baseline risk factors of incident open-angle glaucoma (OAG) in an elderly white population. METHODS: Prospective-longitudinal population-based study. 12 years following baseline examinations, subjects were re-invited for follow-up examinations using the same methodology undertaken at baseline. 1092 (74%) were re-examined. In multivariable logistic regression analysis, factors with a p value of ≤0.2 in univariate analysis were included in the model. RESULTS: Overall, 826 subjects met final inclusion criteria. In multivariable regression analysis adjusted for potential confounders, baseline factors associated with incident glaucoma were: pseudoexfoliation (PEX) (p=0.002); higher intraocular pressure (IOP) (p<0.001); cup-to-disc ratio (p=0.020); family history of glaucoma (p=0.029); history of heart attack (p=0.002), blood pressure (BP) ≤140/90 without anti-hypertensive treatment (p=0.019) compared with BP >140/90. Increased hours of sleep (p=0.043) and alcohol consumption (p=0.030) were found to be protective factors. CONCLUSION: Increased IOP, PEX, increased vertical c/d ratio, family history of glaucoma, history of heart attack and BP ≤140/90 increased the risk for incident OAG. Increased hours of sleep and alcohol consumption were inversely associated with the development of incident glaucoma.
BACKGROUND/AIMS: Ocular surface infections remain a major cause of visual loss worldwide, yet diagnosis often relies on slow or insensitive microbiological techniques. Artificial intelligence may complement emerging mole...BACKGROUND/AIMS: Ocular surface infections remain a major cause of visual loss worldwide, yet diagnosis often relies on slow or insensitive microbiological techniques. Artificial intelligence may complement emerging molecular tools by supporting rapid triage and diagnostic reasoning. This study benchmarked publicly available multimodal large language models (LLMs) against corneal specialists for the diagnosis, treatment and urgency triage of infectious keratitis and conjunctivitis. METHODS: A single-centre diagnostic-accuracy study included 60 microbiologically confirmed infectious keratitis and conjunctivitis cases, each comprising a slit-lamp photograph and a paired clinical vignette. Six multimodal LLMs (GPT-4o, GPT-5, Gemini, Claude, Perplexity and Grok) were evaluated for diagnosis, treatment and urgency triage under three input conditions (image-only, text-only and image+text). Outputs were compared with two corneal specialists. RESULTS: LLM performance depended strongly on input modality. Image-only accuracy was lowest (best GPT-5, 61.4%; κ=0.38) with frequent misclassification of fungal and Acanthamoeba keratitis and hallucinations confined to this setting. Text input improved results (GPT-5, 83.3%; κ=0.78), though accuracy remained below specialists (87-90%; κ≈0.8). Combined image+text achieved near-human accuracy without consistently surpassing corneal specialists (Perplexity 96.7%; κ=0.95; GPT-5 91.7%; κ=0.87). Treatment accuracy remained lower (81-85% vs 90-98%), while urgency triage matched experts in multimodal input. CONCLUSION: Publicly accessible multimodal LLMs can approach expert-level performance in diagnosis and triage when provided with clinical context and slit-lamp images. Gaps in therapeutic reasoning and rare pathogen recognition underscore the need for targeted refinement and validation. These models may complement specialist care, supporting rapid triage and integration with molecular or metagenomic diagnostics, especially in resource-limited settings.
AIMS: To develop and validate a nomogram predicting the risk of implant exposure in patients receiving vicryl-meshed hydroxyapatite (HA) orbital implants following enucleation or evisceration. METHODS: This is a retrospe...AIMS: To develop and validate a nomogram predicting the risk of implant exposure in patients receiving vicryl-meshed hydroxyapatite (HA) orbital implants following enucleation or evisceration. METHODS: This is a retrospective study at the University Hospital of Cologne, which included 336 patients with primary vicryl-meshed HA implants. Univariate and multivariate logistic regression analyses identified independent risk factors for implant exposure. A nomogram was constructed, and its performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves and decision curve analysis (DCA). RESULTS: Independent risk factors for implant exposure included previous ocular trauma (OR 2.08; 95% CI 1.01 to 4.31; p=0.048), diabetes mellitus (OR 4.17; 95% CI 1.81 to 9.63; p<0.001), autoimmune disease (OR 4.69; 95% CI 1.15 to 19.09; p=0.031), chemotherapy or radiotherapy (OR 4.25; 95% CI 1.09 to 16.58; p=0.037), hormone therapy (OR 2.35; 95% CI 1.04 to 5.30; p=0.039) and previous ocular surgery (OR 2.65; 95% CI 1.33 to 5.27; p=0.005). The nomogram demonstrated moderate discriminative ability (AUC 0.725 for both training and validation sets) and good calibration, with potential clinical utility supported by DCA. CONCLUSION: This nomogram provides a practical tool for identifying patients at higher risk of exposure following vicryl-meshed HA implantation and may inform individualised preventive strategies. As this is a single-centre study, its applicability is currently limited to this implant type and wrapping technique, and external validation in other centres and populations is needed to confirm its generalisability.
OBJECTIVE: To identify predictive factors of remission in patients with sarcoid uveitis and to evaluate recurrence rates and patterns following remission. METHODS: Multicentre retrospective study of patients with sarcoid...OBJECTIVE: To identify predictive factors of remission in patients with sarcoid uveitis and to evaluate recurrence rates and patterns following remission. METHODS: Multicentre retrospective study of patients with sarcoid uveitis and a minimum follow-up of 3 years. Remission was defined as the absence of clinical symptoms of sarcoidosis for at least 3 years without treatment. Remission-free Kaplan-Meier survival curves were constructed for selected variables. Cox proportional hazards model was then applied. HRs and 95% CIs were estimated for each variable. Statistical significance was set at the p<0.05 level. Rates and patterns of recurrence after remission were collected and compared with initial presentation. RESULTS: A total of 329 patients were included (62% female, median age 53 years). Remission occurred in 98 (30%) patients after a median follow-up of 6.5 years. Macular oedema at baseline was associated with a lower likelihood of remission (HR, 0.594, 95% CI 0.342 to 0.996, p=0.043), whereas pulmonary involvement at baseline was associated with a higher likelihood of remission (HR, 1.588, 95% CI 1.047 to 2.419, p=0.032). Recurrence after remission occurred in 6 of 98 patients (6%), with a median time to recurrence of 46 months after remission. At recurrence, patients predominantly had anterior uveitis (83%) and shared similar anatomical patterns with their initial presentation. CONCLUSIONS: Approximately one in three patients with sarcoid uveitis achieved remission. Macular oedema at baseline was associated with delayed remission, while lung involvement at baseline was associated with faster remission. Recurrence after remission was uncommon and typically mirrored the initial uveitis phenotype.
BACKGROUND/AIMS: Although 0.01% atropine is widely used for myopia control, its efficacy is debated and its effectiveness across different ethnicities is unknown. We aim to evaluate its efficacy in different ethnic backg...BACKGROUND/AIMS: Although 0.01% atropine is widely used for myopia control, its efficacy is debated and its effectiveness across different ethnicities is unknown. We aim to evaluate its efficacy in different ethnic backgrounds. METHODS: The randomised clinical trials (RCTs) that compared 0.01% atropine against a placebo in myopic children from five databases through August 2025 were included. The primary outcomes included (1) the ratio of the means (RoM), defined as the RoM of annual changes in spherical equivalent refraction (SER) or ocular axial length (AL) in 0.01% atropine to the placebo groups, for accounting in the natural progression; and (2) the mean differences (MDs) in SER progression and AL elongation. RESULTS: A meta-analysis of 25 RCTs (4374 children aged 4-18) showed that 0.01% atropine reduced the SER progression by 37% annually (RoM: 0.63; 95% CI 0.54 to 0.74), with efficacy being much greater in South Asian populations (66% reduction; RoM: 0.34, 95% CI 0.27 to 0.42), than East Asian populations (35% reduction; RoM: 0.65, 95% CI 0.54 to 0.78) and white populations (28% reduction; RoM: 0.72, 95% CI 0.59 to 0.86) (p<0.0001). Regarding the MD, 0.01% atropine was effective in slowing an overall myopia progression of 0.21D per year (95% CI 0.15D to 0.27D) compared with placebo group. A similar pattern was observed in AL elongation. CONCLUSION: 0.01% atropine effectively slows myopia progression across ethnicities, with the greatest efficacy observed in South Asian populations. Clinical practice should consider this ethnic difference to optimise the treatment effects. PROSPERO REGISTRATION NUMBER: CRD42025632545.
The bispectral electroencephalography (BSEEG) method is a simple one-channel quantitative electroencephalography approach that yields a single index, with higher scores previously associated with more severe delirium in...The bispectral electroencephalography (BSEEG) method is a simple one-channel quantitative electroencephalography approach that yields a single index, with higher scores previously associated with more severe delirium in older adults. We prospectively measured BSEEG scores in 21 patients over 60 years old before and 1 month after cataract surgery. BSEEG scores significantly decreased after surgery (p=0.001), and this decrease significantly correlated with improvement in best-corrected visual acuity (r=0.52; p=0.02). Improved visual function after cataract surgery was associated with lower BSEEG scores.
Chia A, Burkill S, Ling Y
… +6 more, Quah BL, Tan D, Tay SA, Tay A, Saw SM, Tan DT
Br J Ophthalmol
· 2026 Mar · PMID 41862182
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AIM: To evaluate the effectiveness of atropine 0.01% in young premyopic and low-myopic children. METHODS: Children (5-9 years old) with premyopia (spherical equivalent refraction, SER+1.00 to -0.49D, n 156) or low myopia...AIM: To evaluate the effectiveness of atropine 0.01% in young premyopic and low-myopic children. METHODS: Children (5-9 years old) with premyopia (spherical equivalent refraction, SER+1.00 to -0.49D, n 156) or low myopia (SER -0.50 to -1.50D, n 52), with at least 1 parent with myopia <-3.00D, were randomised to receive placebo or atropine 0.01% eye-drops in a 1:1 ratio. Cycloplegic autorefraction and axial length were measured every 6 months over 2 years. RESULTS: Mean baseline SER was +0.5+/-0.04D in premyopia and -1.00±0.06D in the low-myopia eyes. Progression over 2 years in premyopic eyes was -0.96±0.10D vs -0.82±0.10D (p=0.328), or 0.72±0.03 mm vs 0.63±0.04 mm (p=0.161) in the placebo and atropine groups, respectively. Progression in eyes remaining emmetropic was -0.43±0.37D vs -0.29±0.37D (p=0.007) or 0.49±0.22 mm vs 0.41±0.38 mm (p=0.209) in the placebo versus atropine-treated eyes, respectively; while eyes which became myopic progressed by -1.78±0.82D vs -1.63±0.82D (p=0.121) or 1.08±0.34 mm vs 0.96±0.14 mm (p=0.010). Incident myopia at 2 years was 42.6% in placebo and 44.8% in atropine 0.01% treated eyes (p=0.896). In the low-myopia group, placebo versus atropine treated eyes progressed by -1.65±0.15D vs -1.23±0.15D (p=0.066) or 0.86±0.07 mm vs 0.68±0.05 mm (p=0.062) at 2 years. There was no difference in near acuity, glare (2.7%) or allergy (6.0%) between treatment groups. CONCLUSIONS: Although there were no significant differences in myopia progression between atropine and placebo treated eyes, there were trends towards less myopic shift in atropine-treated eyes in premyopic eyes which remained emmetropic and in eyes with low myopia.
BACKGROUND: Adalimumab is an effective first-line biologic therapy used to treat children and young people (CYP) with juvenile idiopathic arthritis (JIA) and non-infectious uveitis (NIU). However, the development of neut...BACKGROUND: Adalimumab is an effective first-line biologic therapy used to treat children and young people (CYP) with juvenile idiopathic arthritis (JIA) and non-infectious uveitis (NIU). However, the development of neutralising antibodies may compromise adalimumab's efficacy. This study investigated the incidence and clinical relevance of anti-adalimumab antibody (AAA) development in CYP treated with adalimumab for JIA and/or NIU. METHODS: A retrospective observational study was conducted within a specialist paediatric rheumatology service at a tertiary UK centre. CYPs receiving adalimumab between January 2015 and January 2024 who were tested for AAAs were included. Outcome measures included AAA positivity rate, serum drug levels, concurrent disease-modifying anti-rheumatic drug (DMARD) use, timing of antibody development and patient outcomes following AAA results. RESULTS: Among 390 CYP treated with adalimumab, 112 were tested for AAAs (156 total tests). Overall, 41.0% were AAA positive (>10 mg/L). All CYP with sub-therapeutic drug levels (<3 mg/L) were AAA positive. AAA positivity was higher in CYP not receiving concurrent DMARDs (52.4%) compared with those receiving full-dose methotrexate (21.1%) (OR 4.12, p=0.002). Among AAA-positive patients, 53.1% discontinued adalimumab treatment versus 15.2% of AAA-negative patients (OR 6.3, p<0.0001). Serial testing revealed fluctuating AAA levels, including reductions following corticosteroid use. CONCLUSIONS: High AAA incidence was observed in CYP with JIA and NIU, with most tested during disease flare. AAA positivity correlated with sub-therapeutic drug levels and treatment discontinuation, particularly in the absence of concurrent full-dose methotrexate. Short-term variability in antibody titres suggests that a single positive result may not reliably indicate treatment failure.
BACKGROUND/AIMS: To determine the proportion of progressive retinal nerve fibre layer thickness (RNFLT) change that can be attributed to normal ageing. METHODS: This prospective, longitudinal, cohort study included one e...BACKGROUND/AIMS: To determine the proportion of progressive retinal nerve fibre layer thickness (RNFLT) change that can be attributed to normal ageing. METHODS: This prospective, longitudinal, cohort study included one eye each of 200 patients treated for open-angle glaucoma and 73 healthy control subjects who were followed with optical coherence tomography (OCT) every 6 months. A linear mixed-effects (LME) model was used to estimate the mean RNFLT slope and the difference between the two groups to evaluate factors affecting the slope, while adjusting for other variables. RESULTS: The median (IQR) age and follow-up of all participants was 68.3 (61.8 to 74.7) years and 10.1 (6.4 to 12.9) years, respectively. The median baseline mean deviation in patients with glaucoma was -3.79 (-6.84 to -1.57) dB. Among those classified within normal limits for baseline RNFLT (39 (19.5%) patients with glaucoma and 68 (93.2%) healthy subjects), the individual RNFLT slopes were significantly steeper in patients with glaucoma (median, -0.76 (-1.13 to -0.49) µm/year) compared with healthy subjects (-0.51 (-0.72 to -0.19) µm/year, p<0.01). The LME model showed a statistically significant negative RNFLT slope in healthy subjects (-0.54 µm/year, p<0.01). After adjusting for covariates, diagnosis of glaucoma contributed an additional -0.47 µm/year (p<0.01). Baseline global RNFLT had a slightly negative impact on RNFLT slope (-0.01/year, p<0.01), while baseline age had a significant positive effect (0.01 μm/year, p<0.01). CONCLUSIONS: Normal ageing contributed around one half of RNFLT thinning observed in patients treated for glaucoma.
BACKGROUND/AIMS: To characterise longitudinal refractive changes from the early postoperative period through long-term follow-up after congenital cataract surgery performed within the first 6 months of life. METHODS: Lon...BACKGROUND/AIMS: To characterise longitudinal refractive changes from the early postoperative period through long-term follow-up after congenital cataract surgery performed within the first 6 months of life. METHODS: Longitudinal refractive changes were analysed retrospectively in 219 eyes from 124 patients who underwent surgery at a mean age of 2.9±1.7 months, with a minimum follow-up of 10 years (mean: 13.6±2.3 years; range: 10-18 years). Inclusion required refraction within 1 month postoperatively, at several-month intervals during the first year, and annually thereafter. The cohort included 81 bilateral aphakia, 14 bilateral pseudophakia, 20 unilateral aphakia and nine unilateral pseudophakia cases. RESULTS: In both aphakia and pseudophakia, postoperative refractive change followed an exponential pattern, with pronounced early myopic shifts that progressed gradually thereafter. Plotting refractive change against the logarithm of elapsed postoperative time yielded a linear relationship (aphakia: r=-0.979, p<0.001, pseudophakia: r=-0.893, p<0.001). At the final visit, median myopic shift was -8.4 D (IQR, -11.2 to -5.5 D) in bilateral aphakia and -11.5 D (-17.9 to -7.5 D) in bilateral pseudophakia. In unilateral cases, median anisometropia (operated minus healthy contralateral eye) was -7.8 D (-16.6 to -2.3 D) in aphakia and -11.6 D (-16.9 to -9.6 D) in pseudophakia. CONCLUSIONS: Both aphakic and pseudophakic eyes after congenital cataract surgery exhibited an exponential myopic shift that began in the early postoperative period and continued over a decade.
Infectious keratitis remains a leading cause of corneal blindness and visual impairment worldwide, with bacterial, fungal, amoebic and viral pathogens presenting major diagnostic and therapeutic challenges. Early and pre...Infectious keratitis remains a leading cause of corneal blindness and visual impairment worldwide, with bacterial, fungal, amoebic and viral pathogens presenting major diagnostic and therapeutic challenges. Early and precise pathogen identification is essential to initiate early treatment and prevent irreversible ocular damage. Direct visualisation of pathogens by microscopy of corneal scrapings has been one of the most rewarding and time-tested methods; however, ocular microbiology laboratories seem to be losing the expertise for the same. Culture methods also seem to be losing favour for their long turnaround time and low sensitivity. These have paved the way for newer, rapid and sensitive molecular techniques to make a foray into the realm of diagnosis of non-viral keratitis. This review critically evaluates recent advances in molecular diagnostics for infectious keratitis, focusing on DNA/RNA-based sequencing, real-time PCR (qPCR) and mass spectrometry (MS) and examines their clinical relevance, limitations and potential for point-of-care application.An extensive literature analysis was conducted, integrating findings from peer-reviewed studies published between 2000 and 2025. Emerging diagnostic platforms were compared with conventional microbiological methods in terms of diagnostic accuracy, turnaround time and clinical applicability across paediatric and adult cohorts. Traditional culture-based approaches exhibit limited sensitivity (30%-60%) and slow pathogen detection. In contrast, multiplex and quantitative PCR enable rapid, sensitive and specific pathogen identification, including in culture-negative cases. Next-generation sequencing offers broad-spectrum, culture-independent profiling of bacteria, fungi and protozoa, enhancing diagnostic yield and understanding of pathogen diversity. MS has transformed microbial and host proteomic/metabolomic analyses, identifying candidate biomarkers for disease severity and prognosis. Recent innovations such as portable qPCR devices, clustered regularly interspaced short palindromic repeats-based diagnostics and artificial intelligence-assisted data interpretation extend molecular testing to near-patient settings. The integration of these technologies into routine clinical workflows promises earlier intervention, personalised therapy and improved visual outcomes, particularly in resource-limited environments.
BACKGROUND: The growth of axial length (AL) can lead to high myopia and ocular deformation, especially causing microstructural changes in the fundus, which cannot be fully quantified by AL alone. We propose an optical co...BACKGROUND: The growth of axial length (AL) can lead to high myopia and ocular deformation, especially causing microstructural changes in the fundus, which cannot be fully quantified by AL alone. We propose an optical coherence tomography (OCT)-based modified AL (Myopic Index) to represent the extent of fundus deformation caused by AL elongation and to explore its clinical significance in myopic progression prediction. METHODS: A deep learning model was trained using 27 539 cases of OCT images and referred ocular biometric data to evaluate the Myopic Index. By comparing the Myopia Index with the Measured AL, the difference of two AL indices (DAL) was calculated. We further prospectively employed 2866 cases of OCT images, which were categorised into short AL (Measured AL<22 mm), normal AL (22 mm≤Measured AL<26 mm) and long AL (≥26 mm), to evaluate the model ability of myopic progression prediction. The attention regions of images were also analysed. RESULTS: The Myopia Index was closely correlated with Measured AL (all p<0.001, R²=0.804 in all eyes). Specifically, the Myopia Index was closer to the Measured AL in eyes with long ALs, whereas in eyes with short and normal axial lengths, the Myopia Index clustered around 23-24 mm. The visualisation model demonstrated that for eyes with short and normal ALs, attention regions were primarily concentrated on the retina; conversely, for eyes with long ALs, the choroidal layer and the retinal pigment epithelium layer received more attention. Moreover, DAL was significantly correlated with AL increment (p=0.038). CONCLUSIONS: The Myopia Index reflects the real status of fundus microstructures through fundus microstructures, with a particular focus on the choroid. The Myopia Index demonstrates good predictive capabilities for high myopia progression.
Ischaemic optic neuropathy (ION) is a rare but vision-threatening complication recently linked to GLP-1 receptor agonists, particularly semaglutide. Using over 30 million reports from the FDA Adverse Event Reporting Syst...Ischaemic optic neuropathy (ION) is a rare but vision-threatening complication recently linked to GLP-1 receptor agonists, particularly semaglutide. Using over 30 million reports from the FDA Adverse Event Reporting System (2017-2024), we evaluated formulation- and sex-specific associations. Among 31 774 semaglutide cases, Wegovy demonstrated the strongest signal for ION (reporting odds ratio (ROR)=74.89) compared with Ozempic (ROR=18.81). Sex-stratified analyses showed higher odds in men (ROR=116.37), and multivariable regression confirmed greater risk with Wegovy versus Ozempic (adjusted OR (AOR)=4.74) and in men versus women (AOR=3.33). These findings highlight a potential dose-dependent safety concern that warrants urgent prospective evaluation to guide prescribing and regulatory policy.