Br J Ophthalmol [JOURNAL]
Sun
200 papers
Iberian Registry of Ocular Syphilis (IBERSOS) report 1: epidemiology, clinical spectrum and treatment outcomes of ocular syphilis in the Iberian Peninsula.
Vicente-Antolín M, González-López JJ, Pardiñas Baron N … +16 more , Policarpo-Torres G, Hernanz I, Sánchez Sevila JL, García Tirado A, Carreño E, Jerez Fidalgo M, Llorenç V, Alba-Linero C, Arriola-Villalobos P, Esteban-Ortega M, Martínez-Costa L, Diago T, Leal I, Ajamil-Rodanes S, Fonollosa A, IBERSOS Study Group
Br J Ophthalmol · 2026 Mar · PMID 41791875 · Publisher ↗
PURPOSE: The Iberian Registry of Ocular Syphilis aims to describe the epidemiology, clinical manifestations and treatment outcomes of ocular syphilis in Spain and Portugal. This re-emerging condition, associated with ris...
PURPOSE: The Iberian Registry of Ocular Syphilis aims to describe the epidemiology, clinical manifestations and treatment outcomes of ocular syphilis in Spain and Portugal. This re-emerging condition, associated with rising global syphilis rates and HIV coinfection, presents with diverse ocular and systemic features. The study seeks to fill knowledge gaps regarding incidence, presentation and therapeutic response. METHODS: This multicentre, observational cohort study includes patients aged ≥18 years with newly diagnosed ocular syphilis confirmed by treponemal and nontreponemal serological tests. Conducted across 23 centres, data collection followed routine clinical practice and included demographics, ocular/systemic findings, treatment regimens and outcomes at 3-6 months post-treatment. RESULTS: In the first year, 41 patients met the inclusion criteria, of whom 39 consented to participate in the registry, with an incidence of 0.57 cases per 100 000 persons/year. Most were male (94.9%), especially men who have sex with men (66.7%) and HIV coinfection (20.5%). Bilateral ocular involvement was observed in 64.1% of patients, with anterior segment inflammation in 64.1%, vitritis in 53.8%, retinal or choroidal involvement in 69.2% and optic nerve involvement in 59.0%. Systemic syphilis stage included primary (7.7%), secondary (25.6%) and tertiary or quaternary (15.4%). Treatment was initiated after a mean of 6.2±9.3 weeks after the onset of symptoms, and 2.6±6.0 weeks after the initial presentation at the hospital. Intravenous penicillin G was used in 65.8%, and 61.3% achieved a four-fold titre reduction in the reaginic test at the final visit (3 to 6 months after antibiotic therapy). Final visual acuity improved to 0.17 LogMAR (p<0.001), with 56% of eyes gaining ≥0.1 LogMAR. CONCLUSIONS: Ocular syphilis in the Iberian Peninsula shows a wide clinical spectrum and frequent posterior segment involvement. Most patients achieved favourable serological and visual outcomes. These findings support the effectiveness of standard therapies and highlight the need for early diagnosis, especially in high-risk populations.
Treatment failure in herpes simplex virus type 1 keratitis.
Randag AC, Verjans GM, Remeijer L
Br J Ophthalmol · 2026 Mar · PMID 41786502 · Publisher ↗
Herpes simplex virus type 1 (HSV-1), one of the human herpesviruses, is a frequent cause of recurrent ocular infections. Treatment primarily relies on nucleoside analogues, such as aciclovir (ACV), with or without topica...
Herpes simplex virus type 1 (HSV-1), one of the human herpesviruses, is a frequent cause of recurrent ocular infections. Treatment primarily relies on nucleoside analogues, such as aciclovir (ACV), with or without topical corticosteroids. Treatment failure may be attributed to non-adherence to therapy or inadequate topical corticosteroid dosing, and to a lesser extent to an incorrect diagnosis, coinfection with non-viral pathogens or therapy resistance. ACV resistance (ACV) is relatively rare compared with other reasons for treatment failure, but has been documented in 6% of immunocompetent patients with HSV-1 keratitis. ACV limits the prophylactic and therapeutic efficacy of nucleoside analogues, potentially leading to clinically refractory disease. In this review, we will address the normal pathogenesis of HSV-1 keratitis, the definition and causes of treatment failure in HSV-1 keratitis, a work-up algorithm to be used in the event of treatment failure, the effect of current treatment regimens on the development of ACV keratitis and treatment options for ACV keratitis.
Treating socket discharge and discomfort: a crossover randomised trial of vitamin A ointment, low-dose steroid eyedrops and artificial tears.
Liu AYX, Van Der Meeren SW, Coumou AD … +2 more , Kalmann R, Hartong DT
Br J Ophthalmol · 2026 Mar · PMID 41781183 · Publisher ↗
PURPOSE: This study evaluated the effects of artificial tears, vitamin A ointment and low-dose steroid drops on chronic irritation and discharge in anophthalmic patients wearing ocular prostheses. It also aimed to identi...
PURPOSE: This study evaluated the effects of artificial tears, vitamin A ointment and low-dose steroid drops on chronic irritation and discharge in anophthalmic patients wearing ocular prostheses. It also aimed to identify patient subgroups that may benefit from specific regimens. METHODS: This prospective, crossover randomised trial used a Williams design with 40 ocular prostheses wearing participants aged 16 years or older who experienced chronic discharge or discomfort.Each participant underwent four 2-week intervention periods: artificial tears, vitamin A ointment, low-dose steroids (fluorometholone) and no medication as a control, separated by 2-week washout periods. Visual analogue scale questionnaires assessed discharge and irritation frequency and severity. Data were analysed using linear mixed models with Bonferroni correction for multiple comparisons and subgroup analyses were descriptive. RESULTS: In the total group, vitamin A ointment most consistently improved all outcome parameters: irritation frequency (-1.766, 95% CI (-2.857 to -0.675), p<0.001), irritation severity (-1.448, 95% CI (-2.564 to -0.332), p=0.004), discharge frequency (-1.186, 95% CI (-2.295 to -0.077), p=0.029) and discharge severity (-1.146, 95% CI (-2.177 to -0.114), p=0.021). Artificial tears significantly reduced irritation frequency (-1.279, 95% CI (-2.370 to -0.188), p=0.013). Fluorometholone showed no significant reduction in the total group. Individually, there was considerable variation among the outcomes, indicating that the optimal regimen differs between individuals. CONCLUSIONS: Vitamin A ointment demonstrated the most consistent benefit in anophthalmic patients wearing ocular prostheses, whereas artificial tears and low-dose steroid drops were associated with clinically relevant improvement in a subset of individual patients with chronic irritation and discharge.
Evaluation of corneal epithelial thickness mapping via spectral-domain OCT in patients after allogeneic haematopoietic stem cell transplantation.
Zhao YH, Qu JH, Qu Y … +2 more , Peng RM, Hong J
Br J Ophthalmol · 2026 Mar · PMID 41775510 · Publisher ↗
BACKGROUND: Ocular chronic graft versus host disease (oGVHD) seriously affects ocular surface, which often results in corneal epithelial damage. The purpose of this study is to evaluate corneal epithelial thickness (CET)...
BACKGROUND: Ocular chronic graft versus host disease (oGVHD) seriously affects ocular surface, which often results in corneal epithelial damage. The purpose of this study is to evaluate corneal epithelial thickness (CET) via spectral-domain optical coherence tomography (SD-OCT) in patients who underwent allogeneic haematopoietic stem cell transplantation (HSCT). METHODS: This study included 30 post-HSCT patients along with 20 healthy participants. CET and corneal thickness mapping were performed via SD-OCT and were obtained in multiple predefined corneal regions, namely, the central, superior, inferior, temporal and nasal zones, including both mid and the peri zones. Lid margin irregularity was assessed, and its correlation with CET was evaluated. Statistical analyses, including one-way analysis of variance and Pearson correlation, were used to assess group differences and correlations between CET and lid margin irregularity. RESULTS: Significant differences in corneal CET were observed between post-HSCT patients and healthy controls in several corneal regions, with thinning noted in multiple zones, particularly in the superior and inferior areas, prior to the clinical diagnosis of chronic oGVHD. Additionally, a positive correlation was observed between lid margin irregularity and CET in several peripheral regions, indicating that lid margin changes may contribute to alterations in epithelial distribution. CONCLUSION: The CET map demonstrated that post-HSCT patients with or without chronic oGVHD had a relatively thicker corneal epithelium in the central and inferior regions. These changes were correlated with lid margin morphology. This SD-OCT mapping provides a better understanding of early corneal epithelial alterations following HSCT and identifies potential biomarkers for early diagnosis.
Optical coherence tomography angiography reveals microvascular changes and predicts visual outcomes after decompression surgery for pituitary adenoma.
Lai IP, Huang CW, Yang SH … +8 more , Huang AP, Wang HC, Lai DM, Wang KC, Chen CM, Chen YH, Chou SC, Lin CW
Br J Ophthalmol · 2026 Mar · PMID 41771697 · Publisher ↗
BACKGROUND/AIMS: To evaluate retinal microvascular changes using optical coherence tomography angiography (OCTA) and their prognostic value in patients undergoing transsphenoidal surgery for pituitary adenoma. METHODS: I...
BACKGROUND/AIMS: To evaluate retinal microvascular changes using optical coherence tomography angiography (OCTA) and their prognostic value in patients undergoing transsphenoidal surgery for pituitary adenoma. METHODS: In this prospective study of 90 patients, we assessed best-corrected visual acuity (BCVA), mean deviation (MD) on visual field (VF), and OCTA parameters at the macular region and peripapillary area. RESULTS: Patients with severe VF defects (VFD; MD <-10 dB) showed greater reductions in vessel densities of superficial capillary plexus (SCP) and radial peripapillary capillaries (RPC) than those with minimal VFD (MD >-3 dB) (p=0.021, 0.047). Higher SCP density, RPC density, peripapillary retinal nerve fibre layer (pRNFL) thickness and ganglion cell complex (GCC) thickness were associated with better postoperative visual acuity (r=-0.33, -0.44, -0.24, -0.30; all p<0.05) and MD (r=0.26, 0.46, 0.45, 0.45; all p<0.05). In patients with mild to moderate VFD (MD between -3 and -10 dB), foveal avascular zone area, foveal SCP and deep capillary plexus densities correlated strongly with BCVA outcome (r=0.61,-0.60, -0.63; all p<0.01). Area under the curves for predicting >50% MD improvement were 0.816 (SCP density), 0.784 (RPC density), 0.887 (pRNFL thickness), 0.816 (GCC thickness) and 0.905 (combined; all p≤0.001). CONCLUSIONS: After decompression surgery, retinal vessel densities may further decline at 3 months postoperatively, particularly in patients with severe baseline VFD. Foveal parameters predicted visual acuity in those with mild to moderate VFD, while in severe cases, higher SCP density, RPC density, pRNFL thickness and GCC thickness may serve as prognostic biomarkers for predicting better VF improvement.
Cutting without a blade: a clinical review of hypersonic vitrectomy.
Gandhi S, Balas M, Arjmand P
Br J Ophthalmol · 2026 Mar · PMID 41771696 · Publisher ↗
This review synthesises clinical evidence on hypersonic vitrectomy (HV), examining the gap between its theoretical advantages and observed performance. Originally proposed to reduce vitreoretinal traction and deliver smo...
This review synthesises clinical evidence on hypersonic vitrectomy (HV), examining the gap between its theoretical advantages and observed performance. Originally proposed to reduce vitreoretinal traction and deliver smoother fluidics, HV has achieved successful vitreous removal in human studies, with surgeons reporting favourable qualitative handling. However, comparative trials have yielded mixed results for surgical efficiency versus contemporary pneumatic guillotine vitrectors. Prospective series also describe operational challenges, including intraoperative conversion to guillotine vitrectors in up to 30% of cases, often attributed to inconsistent vitreous liquefaction. Distinct safety considerations have been reported, most notably sclerotomy-site thermal injury and silicone oil emulsification. These findings underscore the difficulty of surpassing a rapidly evolving standard of care. Defining HV's role in vitreoretinal surgery will require continued device refinements and adequately powered, multicentre comparative studies to determine where HV offers clear, reproducible benefits.
Intracapsular metformin bioactivity and its role in posterior capsule opacification.
Spartalis C, Ruiss M, Dechat T … +2 more , Kronschläger M, Findl O
Br J Ophthalmol · 2026 Mar · PMID 41748315 · Publisher ↗
BACKGROUND/AIMS: Posterior capsule opacification (PCO) is the most frequent long-term complication after cataract surgery, caused by proliferation of residual lens epithelial cells (LECs). Metformin, a common antidiabeti...
BACKGROUND/AIMS: Posterior capsule opacification (PCO) is the most frequent long-term complication after cataract surgery, caused by proliferation of residual lens epithelial cells (LECs). Metformin, a common antidiabetic drug with antifibrotic properties, may act as a pharmacological modulator of this process. The purpose was to assess whether systemically administered metformin reaches the human lens capsule and inhibits LEC proliferation at physiologically relevant concentrations. METHODS: Metformin concentrations were quantified in serum and lens capsule tissue of patients with type 2 diabetes mellitus undergoing cataract surgery using high performance liquid chromatography-tandem mass spectrometry. Patients were stratified into low-dose (≤1000 mg/day) and high-dose (>1000 mg/day) groups. Additionally, anterior lens capsules from non-diabetic donors were cultured with or without metformin (0.75 pg/µL), and LEC proliferation was monitored for 14 days by live-cell imaging. RESULTS: Metformin was detectable in both serum and capsule specimens, with a significant correlation between compartments (r=0.553, p=0.011). Capsule concentrations were similar across dose groups, while serum levels were higher in the low-dose group. In vitro, metformin significantly reduced LEC proliferation compared with controls (p<0.001). CONCLUSION: Systemically administered metformin reaches the human lens capsule in vivo and suppresses LEC proliferation in vitro at clinically relevant concentrations. These findings provide first clinical and experimental evidence supporting metformin as a potential pharmacological adjunct to current strategies for PCO prevention.
Outcome reporting bias in ophthalmology clinical trials between 2014 and 2023.
Li X, Tien M, Huang RS … +7 more , Hanna A, Acharya S, Lusterio A, Hsiao H, Tao B, Xie JS, Margolin E
Br J Ophthalmol · 2026 Feb · PMID 41748314 · Publisher ↗
BACKGROUND: Outcome-reporting bias (ORB), characterised by selective outcome reporting, may exaggerate intervention efficacy and safety, compromising clinical guidelines and patient care. This cross-sectional analysis in...
BACKGROUND: Outcome-reporting bias (ORB), characterised by selective outcome reporting, may exaggerate intervention efficacy and safety, compromising clinical guidelines and patient care. This cross-sectional analysis investigated the prevalence and extent of ORB in seminal ophthalmic randomised controlled trials (RCTs). METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched Embase, MEDLINE and CENTRAL for ophthalmic RCTs published in the 10 highest-impact ophthalmic and general medical journals from 2014 to 2023. Outcomes were incompletely reported if they lacked sufficient data for meta-analysis and unreported if specified in protocols but absent from publications. Logistic regression evaluated associations between incomplete reporting and trial or journal characteristics. The association between outcome unfavourability (ie, failure to demonstrate superiority, non-inferiority or equivalence) and incomplete reporting was calculated as OR and synthesised into a meta-analysis. Discrepancies between prespecified and published outcomes were examined. RESULTS: Of 9436 records, 260 RCTs met inclusion criteria. Among these, 167 (64.2%) and 124 (47.7%) trials had at least one incompletely reported outcome and unreported outcome, respectively. Unreported outcome was associated with lower 5-year impact factor (adjusted OR (aOR): 1.02, 95% CI 1.00 to 1.05, p=0.04, per 1.0 reduction), receiving only industry funding (OR: 1.98, 95% CI 1.02 to 3.85, p=0.04) or not declaring funding compared to non-industry funding (aOR: 3.52, 95% CI 1.22 to 10.18, p=0.02). Unfavourable outcomes were more likely to be incompletely reported than favourable ones (OR: 3.31, 95% CI 2.41 to 4.56, p<0.001). Outcome discrepancies occurred in 121 trials (46.5%). CONCLUSIONS: ORB is prevalent in ophthalmic RCTs. Strengthening adherence to prespecified protocols and improving transparency in reporting are essential.
Malignant melanocytic lesions in clinically suspected pterygium.
Hajdu RI, Kammrath Betancor P, Touirssa O … +3 more , Auw-Haedrich C, Reinhard T, Nuessle S
Br J Ophthalmol · 2026 Feb · PMID 41748313 · Publisher ↗
AIMS: To determine the prevalence and clinicopathological features of malignant melanocytic lesions in specimens clinically diagnosed as pterygia. METHODS: This retrospective study analysed all conjunctival specimens sub...
AIMS: To determine the prevalence and clinicopathological features of malignant melanocytic lesions in specimens clinically diagnosed as pterygia. METHODS: This retrospective study analysed all conjunctival specimens submitted with the clinical diagnosis 'pterygium' to the ophthalmic pathology laboratory of the Eye Center, University of Freiburg, Germany, between August 1999 and August 2024. Specimens that unexpectedly revealed a histopathological diagnosis of malignant melanocytic lesions were further reviewed for their clinical and pathological characteristics. RESULTS: Among 2298 clinically presumed pterygia, seven specimens (0.30%) harboured a malignant melanocytic lesion: four (0.17%) were invasive conjunctival melanomas and three (0.13%) were high-grade conjunctival melanocytic intraepithelial lesions (C-MIL). Three of four melanomas were amelanotic or hypomelanotic (75%) or exhibited atypical temporal localisation (75%). CONCLUSION: Malignant melanocytic lesions, though rare, may arise within or mimic pterygia. Their often amelanotic presentation can complicate clinical recognition. Routine histopathological evaluation of all excised pterygia is therefore essential to detect unexpected malignancies as conjunctival melanoma C-MIL.
Aetiology, characteristics and workup of early onset high myopia.
Son HS, Zeng A, Jacobsen VP … +9 more , Welk G, Niknahad A, VandeLune J, Bragg TL, Zhao L, Ruggeri ML, Drack AV, Dumitrescu AV, Doyle JJ
Br J Ophthalmol · 2026 Feb · PMID 41748312 · Full text
BACKGROUND: Early-onset high myopia (eoHM) associates with multiple ocular and systemic disorders. This study evaluates the repertoire and relative prevalence of these disorders in a tertiary care setting, parses them by...
BACKGROUND: Early-onset high myopia (eoHM) associates with multiple ocular and systemic disorders. This study evaluates the repertoire and relative prevalence of these disorders in a tertiary care setting, parses them by eoHM and other characteristics and evaluates the utility of diagnostic workup. METHODS: We performed a retrospective analysis of eoHM cases seen at two US eye centres from 2012 to 2022. eoHM was defined as a myopic refraction requiring glasses when ≤2 years of age and/or a refraction greater than -6D by 6 years of age. We reviewed the extent and outcome of workup, including ocular examination, imaging, electrophysiology, systemic evaluation and genetic testing. RESULT: Of 407 patients with eoHM, 39% had an associated ocular disorder, 21% had a systemic disorder and 40% had apparently isolated eoHM (ie, no associated condition). Patients with associated disorders often reported typical presenting complaints but were more likely to be seen earlier in life, to possess severe, symmetric or very asymmetric eoHM and to display other stigmata of visual dysfunction. Patients with connective tissue disorders and select inherited retinal disorders had the most severe and symmetric eoHM compared with other conditions or isolated cases. Electroretinography and genetic testing were critical workup components. CONCLUSIONS: eoHM frequently associates with a wide array of ocular and systemic disorders and may display distinct clinical characteristics depending on the associated condition. Awareness of the range of disorders that present with eoHM, key distinguishing characteristics, the role of timely and targeted workup and the importance of an accurate diagnosis are key considerations.
Patient perceptions of artificial intelligence in ophthalmology: a cross-sectional survey study.
McCarthy A, Eltemsah L, Cui A … +4 more , Diamond ME, Golebka J, Thakoor KA, Dagi Glass LR
Br J Ophthalmol · 2026 Feb · PMID 41748311 · Publisher ↗
BACKGROUND/AIMS: Patients have largely been excluded from discussions on the use of their health data in developing medical artificial intelligence (AI), despite being directly affected by its integration into care. This...
BACKGROUND/AIMS: Patients have largely been excluded from discussions on the use of their health data in developing medical artificial intelligence (AI), despite being directly affected by its integration into care. This study assessed ophthalmology patients' perspectives on AI to inform patient-aligned development and implementation. METHODS: We conducted a cross-sectional survey across ophthalmology clinics in a large academic hospital system in New York City. Consecutive patients were approached in waiting rooms by a research coordinator to maximise sociodemographic diversity and minimise bias from digital literacy or access. The survey, developed by experts in AI, ethics, ophthalmology and survey methodology, was administered via paper and Qualtrics. It addressed attitudes towards AI in clinical scenarios, willingness to share various types of personal data for AI model development and understanding of AI in ophthalmology. RESULTS: Among 403 respondents, 67% reported a low or no understanding of AI, and 71% expressed interest in learning more. Patients prioritised physician involvement and transparency. Comfort decreased with task complexity: highest for screening, lower for diagnosis and lowest for treatment/surgery. For model development, patients were more comfortable sharing de-identified optical coherence technology or lab data than facial images or genetic data. 90% felt consent was always necessary when using personal data to train AI models. CONCLUSIONS: These findings highlight the need for patient education and robust data consent protocols. Implementing an opt-out system for retrospective data use may enhance trust while supporting innovation. Integrating patient perspectives into AI governance can foster trust and transparency in ophthalmology and beyond.
Aqueous humour outflow improvement after excimer laser trabeculostomy.
Kallab M, Vieboeck I, Panahi P … +4 more , Mansouri K, Bolz M, Huang AS, Strohmaier C
Br J Ophthalmol · 2026 Feb · PMID 41708277 · Full text
The purpose of the study was to investigate changes in aqueous humour outflow (AHO) after the Elios glaucoma procedure (excimer laser trabeculostomy, ELT) using sequential AHO angiography. AHO angiography using two diffe...
The purpose of the study was to investigate changes in aqueous humour outflow (AHO) after the Elios glaucoma procedure (excimer laser trabeculostomy, ELT) using sequential AHO angiography. AHO angiography using two different tracers was performed in six eyes of five patients undergoing cataract surgery combined with ELT. AHO was compared in regions of interest in the nasal quadrant.AHO improved significantly after ELT (p=0.03) overall, and each patient showed individual, qualitative AHO improvement. Interestingly, AHO improvement extended beyond the site of ELT application. Further studies are needed to investigate the correlation of AHO improvement and clinical efficacy.
Long-term outcomes of and a risk score model for moderate-risk to high-risk penetrating keratoplasty.
Zheng Z, Zhang Y, Peng W … +4 more , Gong X, Zhang J, Wang C, Zhou S
Br J Ophthalmol · 2026 Feb · PMID 41702686 · Publisher ↗
BACKGROUND/AIMS: To develop a risk score for moderate-risk to high-risk penetrating keratoplasty (PK) based on various risk factors and use it to stratify grafts. METHODS: We collected data on clinical features and survi...
BACKGROUND/AIMS: To develop a risk score for moderate-risk to high-risk penetrating keratoplasty (PK) based on various risk factors and use it to stratify grafts. METHODS: We collected data on clinical features and survival status from the electronic health records of patients who underwent moderate-risk to high-risk PK between January 2012 and December 2021. Feature selection was performed using multivariate Cox regression analyses. The risk score was derived from the coefficient of variables obtained through the Cox proportional hazards model. The performance of the risk score was assessed using receiver operating characteristic curve analysis. Risk stratification was performed based on the risk scores. RESULTS: The study cohort comprised 2297 eyes (2166 patients) subjected to moderate-risk to high-risk PK. The risk score was derived based on six variables. Each variable was assigned a score of 0, 1, 2 or 3 based on its coefficient. The discriminative ability of this score was robust, achieving an area under the receiver operating characteristic curve of 0.747 in the external validation cohort, which surpassed the predictive performance of any single variable alone. According to the established risk score, patients were stratified into three distinct prognostic subgroups: moderate-risk (0-2 points), high-risk (3-5 points) and extremely high-risk groups (≥6 points). The survival curves across these stratified groups differed significantly (log-rank test, p<0.001). CONCLUSION: The risk score demonstrated good discriminatory ability for moderate-risk to high-risk PK and can help to further stratify these grafts.
The Manchester buckle study: 15-year outcomes and predictive factors for success in scleral buckling for primary rhegmatogenous retinal detachment.
Lippera M, Kiraly P, Ally N … +10 more , Alnafisee N, Agarwal R, Jalil A, Ivanova T, Moussa G, Dhawahir-Scala F, Patton N, Turner G, Charles S, Jasani K
Br J Ophthalmol · 2026 Feb · PMID 41702685 · Publisher ↗
AIMS: To assess the long-term anatomical and visual outcomes of primary scleral buckle (SB) surgery for rhegmatogenous retinal detachment (RRD) and identify predictors of surgical and functional success. METHODS: All pri...
AIMS: To assess the long-term anatomical and visual outcomes of primary scleral buckle (SB) surgery for rhegmatogenous retinal detachment (RRD) and identify predictors of surgical and functional success. METHODS: All primary SB procedures performed at Manchester Royal Eye Hospital between January 2008 and December 2023 were reviewed retrospectively. Preoperative, intraoperative and postoperative data were extracted from electronic records. Primary end-points were single-surgery anatomical success (SSAS) and final best-corrected visual acuity (BCVA); univariate and multivariate regression analyses examined predictive variables and complications. RESULTS: 608 eyes were included. SSAS was achieved in 515 eyes (85%) and final anatomical success in 602 eyes (99%). Mean BCVA improved from 0.62±0.85 to 0.32±0.49 logarithm of the minimum angle of resolution (logMAR) (p<0.01). On multivariate analysis, age >40 years (OR 0.55, 95% CI 0.37 to 0.83; p=0.004), macula-off status (OR 0.65, 95% CI 0.44 to 0.97; p=0.034) and ocular trauma (OR 0.40, 95% CI 0.19 to 0.82; p=0.012) independently reduced SSAS. For visual outcomes, macula-off detachment (β=+0.36; p<0.001) and ocular trauma (β=+0.42; p<0.001) were independent predictors of worse postoperative BCVA. The most common complications were subretinal haemorrhage (4.6%), inadvertent deep sutures (3.9%) and postoperative ocular hypertension (7.4%). CONCLUSIONS: Primary SB provided high anatomical success, significant visual improvement and a favourable safety profile in this large single-centre study. Age above 40 years, macula-off status and ocular trauma predicted poorer SSAS; trauma and macula-off status were also associated with worse postoperative BCVA on multivariate logistic regression.
Biomarker changes of choroidal architecture preceding myopia onset in Chinese school children: a 3-year prospective cohort study.
Wu H, Wang Y, Li X … +7 more , Liu M, Lu Y, Liu M, Rui X, Sun Y, Qu J, Zhou X
Br J Ophthalmol · 2026 Feb · PMID 41690696 · Publisher ↗
BACKGROUND/AIMS: To characterise the temporal dynamics of choroidal changes relative to myopia onset and determine their associations with myopia onset in school children. METHODS: The 3-year prospective cohort study con...
BACKGROUND/AIMS: To characterise the temporal dynamics of choroidal changes relative to myopia onset and determine their associations with myopia onset in school children. METHODS: The 3-year prospective cohort study consisted of 180 emmetropic school-children. Cycloplegic auto-refractions were performed annually. Choroidal images acquired via swept-source optical coherence tomography until myopia onset were analysed. Choroidal architecture was characterised based on submacular choroidal thickness (ChT), choroidal vascularity index (CVI), luminal area (LA), stromal area (SA) and total choroidal area (TCA) measurements. Time to myopia onset was defined as the first annual follow-up visit with spherical equivalent ≤-0.50 dioptres. RESULTS: A total of 165 participants (330 eyes, 91.7%) who completed at least one annual follow-up were included. During 36 months, 168 eyes of 100 participants developed myopia. Refractive shift and axial elongation showed significant non-linear trends in which they accelerated dramatically approximately 2 years prior to myopia onset. Notably, ChT, as well as CVI, LA, SA and TCA, exhibited significant linear declines throughout the 3 years when these eyes progressed to myopia, whereas they remained unchanged in persistent non-myopic eyes. Multivariable accelerated failure time models showed that a greater decline rate of these choroidal parameters (per SD) shortened the time to myopia onset, with time ratios ranging from 1.26 to 1.76. The area under receiver-operating characteristic curves for annual choroidal changes effectively distinguished incident myopia (0.83-0.89). CONCLUSIONS: Alterations in choroidal architecture are an early indicator for the disruption of normal emmetropisation and the onset of myopia.
Trends in follow-up visits and visual acuity gain in infectious keratitis: report from a tertiary eye care centre.
Singh RB, Velankar L, Mandell J … +1 more , Jhanji V
Br J Ophthalmol · 2026 Feb · PMID 41690695 · Publisher ↗
BACKGROUND: Infectious keratitis (IK) is a leading cause of corneal blindness globally. While treatment can limit infection-related complications, the timeline and predictors of visual recovery in IK remain poorly charac...
BACKGROUND: Infectious keratitis (IK) is a leading cause of corneal blindness globally. While treatment can limit infection-related complications, the timeline and predictors of visual recovery in IK remain poorly characterised. METHODS: We conducted a retrospective cohort study of 966 patients (984 eyes) with non-viral IK at a tertiary eye care centre (2018-2023). Electronic health records were reviewed for microbiologic data, and best-corrected visual acuity (BCVA) measured at presentation and up to 90 days. Outcomes included change in BCVA evaluated across time intervals. Spearman correlation assessed associations between BCVA change and number of follow-up visits. RESULTS: The average presenting BCVA was 1.04±0.95 logMAR (20/200), improving to 0.75±0.88 logMAR (20/112) at 90 days (-0.29 logMAR; p<0.001). The average number of follow-up visits was 4.18 days within the 90-day follow-up. 27.2% had culture-proven infections, predominantly bacterial (65.6%). Culture-positive cases had poorer initial vision (1.51±0.94 logMAR) but improved significantly (-0.43 logMAR; p<0.001). Most visual recovery occurred after 4 weeks of treatment. Poorer presenting BCVA correlated with higher follow-up visit frequency (ρ=0.37, p<0.001). A significant correlation was observed between BCVA improvement and number of visits (ρ=0.14, p<0.001). Bacterial keratitis showing better recovery than fungal, Acanthamoeba and polymicrobial infections. Surgical intervention was required in 3.5% of eyes, primarily in fungal, and polymicrobial cases. CONCLUSIONS: Most visual improvement after IK occurs after 4 weeks, emphasising the need for continued follow-up and patient counselling regarding expected recovery timelines. Outcomes vary by initial severity and causative organism, highlighting opportunities for stratified management in IK.
Incidence and treatment patterns of acute retinal necrosis: a nationwide population-based cohort study.
Akada M, Hata M, Muraoka Y … +7 more , Ishihara K, Kadomoto S, Ueshima H, Tamura H, Tsujikawa A, Miyake M, Usui Y
Br J Ophthalmol · 2026 Feb · PMID 41679958 · Publisher ↗
AIMS: To quantify nationwide incidence and contemporary treatment patterns of acute retinal necrosis (ARN). METHODS: Retrospective cohort using Japan's National Database of Health Insurance Claims and Specific Health Che...
AIMS: To quantify nationwide incidence and contemporary treatment patterns of acute retinal necrosis (ARN). METHODS: Retrospective cohort using Japan's National Database of Health Insurance Claims and Specific Health Checkups, which covers >95% of claims. New-onset ARN (2016-2022) was identified by ARN diagnostic codes plus antiviral therapy. Annual, age-specific and sex-specific incidence rates used governmental denominators; age-standardised rates used the WHO world standard. Surgical management (vitreoretinal surgery, silicone oil (SO)/perfluorocarbon (PFC) use, glaucoma surgery) was assessed up to 2 years after diagnosis. RESULTS: Among 586 incident cases (313 men, 273 women), crude incidence was 0.066 (95% CI 0.061 to 0.072) per 100 000 person-years; the age-standardised rate was 0.040 per 100 000 person-years. Incidence rose with age, peaking at 70-74 years, and was consistently higher in men than in women. Vitreoretinal surgery occurred in 42.4% by 30 days and 59.4% by 365 days after diagnosis; 25.1% underwent ≥2 procedures within 1 year. SO or PFC was used in 40.8% by 1 year. Glaucoma surgery was uncommon (<2% by 2 years). CONCLUSION: In the largest population-based study of ARN to date, nationwide incidence in Japan closely matched prior UK estimates, suggesting cross-system consistency in ARN epidemiology. Management was characterised by early, intensive surgery with frequent tamponade use and substantial reoperation, informing clinical triage and resource planning for this rare, vision-threatening condition.
Keeping a PROMise: embedding patient voices in ophthalmic outcomes.
Crabb DP
Br J Ophthalmol · 2026 Apr · PMID 41672738 · Publisher ↗
Abstract loading — click title to view on PubMed.
Trauma-related eye removal is associated with increased psychiatric morbidity compared to other surgical indications: a retrospective cohort study.
Davila N, Shields C, Pradeep T … +3 more , Mclaughlin S, Wong B, Lee WW
Br J Ophthalmol · 2026 Feb · PMID 41672737 · Publisher ↗
BACKGROUND/AIMS: To evaluate psychiatric outcomes following enucleation or evisceration (EE) and determine whether these outcomes differ by the underlying aetiology related to surgery, including trauma, blind painful eye...
BACKGROUND/AIMS: To evaluate psychiatric outcomes following enucleation or evisceration (EE) and determine whether these outcomes differ by the underlying aetiology related to surgery, including trauma, blind painful eye, infection and malignancy. METHODS: This retrospective cohort study utilised the TriNetX Research Network, analysing deidentified records of 20 109 patients who underwent EE. Psychiatric outcomes were compared with 325 108 patients who underwent other major ocular surgeries. Patients were propensity-score matched, and EE cases were stratified into trauma, blind painful eye, infection or malignancy cohorts. Outcomes included new diagnoses of depression, anxiety, stress and adjustment disorders, substance use disorders and new prescriptions of antidepressants or anxiolytics within 1 year. Predictors of psychiatric outcomes were evaluated using the Cox proportional hazards models at 3 years postindex. RESULTS: Compared to matched controls, the EE cohort had higher rates of antidepressant use (risk ratio, RR 1.14; 95% CI, 1.04 to 1.25; p<0.01) and anxiolytic use (RR 1.15; CI, 1.07 to 1.25; p<0.01), despite similar diagnostic rates of depression. Among subgroups, trauma-related EE was uniquely associated with elevated risk of depression (RR 1.85; CI, 1.06 to 3.21; p=0.03), antidepressant use (RR 2.18; CI, 1.45 to 3.26; p<0.01), anxiolytic use (RR 1.63; CI, 1.13 to 2.33; p<0.01) and substance use disorders (RR 2.04; CI, 1.10 to 3.79; p=0.02). Trauma remained an independent predictor of depression after adjusting for psychiatric history and covariates (HR 1.34; CI, 1.11 to 1.62; p<0.01). CONCLUSION: Psychiatric morbidity following eye removal is influenced by related surgical aetiology. Trauma-related EE carries a distinctly higher psychiatric burden, supporting the need for targeted mental health screening and intervention in this vulnerable subgroup.
Recovery of corneal sensation following eyelid surgery for neurotrophic keratopathy and preganglionic facial palsy.
Moledina M, Lim C, Dua HS … +1 more , Malhotra R
Br J Ophthalmol · 2026 Jun · PMID 41667221 · Publisher ↗
BACKGROUND/AIMS: Facial nerve palsy (FNP) impacts the ocular and periocular regions. Preganglionic trigeminal nerve palsy (PrGTP) may complicate preganglionic FNP (PrGFP), resulting in neurotrophic keratopathy (NK), risk...
BACKGROUND/AIMS: Facial nerve palsy (FNP) impacts the ocular and periocular regions. Preganglionic trigeminal nerve palsy (PrGTP) may complicate preganglionic FNP (PrGFP), resulting in neurotrophic keratopathy (NK), risking corneal sequelae. We present a case series where comprehensive eyelid surgery (CES) to manage the eyelid sequelae of PrGFP, complicated by PrGTP, resulted in the recovery of corneal sensation, avoiding corneal neurotisation surgery (CNS). METHODS: A retrospective case series of three patients with PrGFP and PrGTP in whom eyelid abnormalities were addressed through CES. Outcome measures include markers of trophic function, including ocular surface integrity as determined by fluorescein assessment of cornea staining and corneal sub-basal nerve plexus density (CSND) via in vivo confocal microscopy where available. Corneal scarring was assessed, and corneal sensitivity was determined via Cochet-Bonnet or corneal wisp testing. RESULTS: Three patients with longstanding PrGFP and PrGTP (mean of 28.3 (range 18-49) months) underwent CES to correct the eyelid sequelae of FNP. On presentation, two out of three cases had a complete absence of corneal sensation, while one out of three had reduced sensation. All cases had absent trophic nerve function. Following CES, trophic function and corneal sensation started to improve on average 19 days and 10 months later, respectively, for the three patients. CSPD had nearly doubled at 6 months postoperatively in the patient who had this assessed. CONCLUSIONS: In cases of NK due to PrGTP complicated by PrGFP, CES should be attempted before considering CNS since improvement in corneal sensation and trophic function may occur. CES helps to reduce exposure and may improve corneal sensation regardless of aetiology.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe