Br J Ophthalmol [JOURNAL]
Sun
200 papers
Peripheral retinal lesions in highly myopic children: prevalence, types and biometric correlates.
Bijon J, Brach L, Boulanger E … +7 more , Chehaibou I, Couturier A, Panda-Jonas S, Abdelmassih Y, Bonnin S, Caputo G, Chapron T
Br J Ophthalmol · 2026 May · PMID 41655206 · Publisher ↗
AIMS: To evaluate prevalence, types and biometric predictors of peripheral retinal lesions in highly myopic children. METHODS: Retrospective cross-sectional study at a tertiary centre. Participants were aged 4-17 years w...
AIMS: To evaluate prevalence, types and biometric predictors of peripheral retinal lesions in highly myopic children. METHODS: Retrospective cross-sectional study at a tertiary centre. Participants were aged 4-17 years with high myopia (≤-4.00 dioptres (D) at 4-6 years; ≤-6.00 D at 7-17 years). Peripheral retina was assessed by ultra-widefield imaging (UWF) and/or documented dilated ophthalmoscopy. RESULTS: We analysed 160 eyes from 89 children (mean age 10.4±3.8 years; mean spherical equivalent -9.95±3.59 D; mean axial length (AL) 26.68±1.82 mm). Peripheral lesions were present in 87/160 eyes (54.4%), more frequent in 7-17-year-olds than in 4-6-year-olds (59.4% vs 34.4%) (p<0.05). Among affected eyes, 50/87 (57%) had a single lesion and 37/87 (43%) multiple; multiplicity increased with age (p<0.001). The most frequent lesions were dark without pressure (46/160; 28.7%), white without pressure (32/160; 20.0%), snail-track degeneration (15/160; 9.4%), microcystoid degeneration (11/160; 6.9%) and lattice degeneration (10/160; 6.3%). In multivariate models, AL was the strongest independent predictor of both lesion prevalence (OR=1.45; 95% CI 1.07 to 2.03; p=0.021) and multiplicity (OR=2.17; 95% CI 1.53 to 3.07; p<0.001). Model-derived lesion probability reached 50% at AL 26.2 mm and 80% at 29.4 mm. CONCLUSIONS: Peripheral retinal lesions are common in paediatric high myopia and related strongly to AL. Early peripheral retinal assessment using UWF imaging or thorough dilated examination may enhance risk stratification and surveillance.
Nationwide age-, sex-, cause-specific burden of blindness and vision impairment in China.
Guo X, Xiong R, Yao J … +6 more , Li H, Zhu Z, Chen Y, Huang W, He M, Wang W
Br J Ophthalmol · 2026 Feb · PMID 41621862 · Publisher ↗
BACKGROUND: Despite over 90% of vision impairment (VI) being preventable, in China, a routine screening programme is currently unavailable in primary healthcare. Robust epidemiological evidence is needed to guide nationa...
BACKGROUND: Despite over 90% of vision impairment (VI) being preventable, in China, a routine screening programme is currently unavailable in primary healthcare. Robust epidemiological evidence is needed to guide national strategies. METHOD: Using Global Burden of Disease 2021 data, we estimated prevalence, years lived with disability (YLDs), and age-standardized rates of VI by cause and severity. Temporal changes were decomposed into contributions from population growth, ageing, and shifts in age-specific prevalence. Estimated annual percentage changes (EAPCs) assessed trends, and Bayesian age-period-cohort models projected burden to 2040. RESULTS: In 2021, China had 767.4 million (95% UI 576.6 to 1009.3) VI cases, comprising: 324.4 million (237.7 to 435.4) uncorrected presbyopia, 4.1 million (3.4 to 5.0) moderate VI, 46.7 million (39.4 to 55.3) severe VI and 8.6 million (7.0 to 10.2) blindness. Population ageing emerged as the predominant driver, accounting for 164.25% of the cataract-related burden increase. Women had a higher burden than men (53.79% of cases; 54.87% of YLDs), and the burden peaked at older ages. Uncorrected refractive errors and cataracts were the leading aetiologies, constituting 50.65% of moderate VI and 35.08% of blindness. Projections indicate that by 2040, the age-standardised YLD rate for VI may nearly double from 2021 levels, reaching 596.4 (95% UI 72.0 to 1240.4) per 100 000 population. CONCLUSIONS: VI is a growing public health challenge in China, driven primarily by ageing. Many cases are preventable, underscoring the need for targeted interventions, particularly among women and older adults.
Long-term outcomes of Aurolab aqueous drainage implant in adults with refractory glaucoma.
Puthuran GV, Palmberg PF, Talla S … +7 more , Mathews AM, Khilar JK, Anto M, Mani I, Krishnadas SR, Robin AL, Gedde SJ
Br J Ophthalmol · 2026 Jan · PMID 41611470 · Publisher ↗
PURPOSE: To report long-term outcomes of Aurolab aqueous drainage implant (AADI) surgery in adults with refractory glaucoma. DESIGN: Retrospective, non-comparative, interventional case series. METHODS: Case records of pa...
PURPOSE: To report long-term outcomes of Aurolab aqueous drainage implant (AADI) surgery in adults with refractory glaucoma. DESIGN: Retrospective, non-comparative, interventional case series. METHODS: Case records of patients aged >18 years who underwent AADI surgery between 2012 and 2018 and had >5 years of follow-up were reviewed. Intraocular pressure (IOP), visual acuity, number of IOP-lowering medications, complications and reoperations were recorded at baseline and at 1 day, 1 month, 3 months, 6 months, 1 year and annually thereafter. Failure was defined as IOP>21 mmHg or reduced<20% below the baseline, IOP≤5 mmHg, reoperation for glaucoma or a complication or loss of light perception vision. RESULTS: The study included 282 eyes from 282 patients. Age (mean±SD) was 45.2±12.3 years, and 191 (68%) were men. Secondary angle closure glaucoma was the most common aetiologic group (30%), followed by secondary open angle glaucoma (25%) and primary open angle glaucoma (22%). IOP (mean±SD) decreased from 33.1±10.4 mmHg at baseline to 16.5±6.5 mmHg at 5 years. The cumulative probability of failure was 34.4% (95% CI 29.2 to 40.3) at 5 years. Corneal endothelial decompensation was the most common complication occurring in 32 eyes (11%). Delayed hypotony was seen in only four eyes (1.4%). After adjusting for age, sex and previous trabeculectomy, eyes with secondary glaucoma had a 32% lower risk of failure (HR=0.68, 95% CI 0.50 to 0.94, p=0.02). CONCLUSION: The AADI showed good control of IOP over 5 years, but corneal endothelial decompensation remains a concern.
Associations between obesity, metabolic syndrome and glaucoma in the National Institutes of Health 'All of Us' research programme.
Paul M, Lee J, Kitayama K … +4 more , Pan D, Yu F, Tseng VL, Coleman AL
Br J Ophthalmol · 2026 Jan · PMID 41605611 · Publisher ↗
BACKGROUND/AIMS: The literature surrounding the relationship between obesity and glaucoma is conflicting. The aim of this study was to examine associations between obesity, metabolic syndrome (MetS) and glaucoma prevalen...
BACKGROUND/AIMS: The literature surrounding the relationship between obesity and glaucoma is conflicting. The aim of this study was to examine associations between obesity, metabolic syndrome (MetS) and glaucoma prevalence in the National Institutes of Health All of Us (AoU) research programme. METHODS: 156 362 individuals over age 40 were included in analyses. Obesity was defined by (1) body mass index (BMI) and (2) central obesity based on waist circumference (WC). MetS was defined as ≥3 of the following: central obesity (CO), triglycerides ≥150 mg/dL, high-density lipoprotein cholesterol (<40 mg/dL for men and <50 mg/dL for women), blood pressure ≥130/85 mm Hg and fasting glucose ≥100 mg/dL or non-fasting glucose ≥140 mg/dL. Metabolic Syndrome Severity Score (MSSS) was captured as a continuous measure of MetS. Logistic regression models examined associations between (1) BMI, (2) CO, (3) WC, (4) MetS, (5) MSSS and glaucoma prevalence. RESULTS: Overweight (OR 0.80 (95% CI 0.74 to 0.86)) and obese (OR 0.79 (95% CI 0.74 to 0.85)) individuals based on BMI and those with CO (OR 0.87 (95% CI 0.83 to 0.93)) and increased WC (OR 0.97 (95% CI 0.95 to 0.99)) had lower odds of glaucoma compared with non-overweight individuals. Individuals with MetS (OR 1.35 (95% CI 1.27 to 1.44)) and higher MSSS (OR 1.19 (95% CI 1.16 to 1.22)) had increased odds of glaucoma compared with individuals without MetS. CONCLUSION: In AoU, higher BMI and increased WC were associated with a lower likelihood of glaucoma, while MetS was associated with an increased likelihood of glaucoma.
Corneal confocal microscopy as a paraclinical test in neurodegenerative disease: a scoping review.
Oreskovic E, Petzold A, Petropoulos IN … +1 more , Hau S
Br J Ophthalmol · 2026 Jan · PMID 41605610 · Publisher ↗
Corneal confocal microscopy (CCM) is a non-invasive imaging technique that enables quantification of the corneal sub-basal nerve plexus and has emerged as a potential surrogate biomarker for peripheral neurodegeneration....
Corneal confocal microscopy (CCM) is a non-invasive imaging technique that enables quantification of the corneal sub-basal nerve plexus and has emerged as a potential surrogate biomarker for peripheral neurodegeneration. This scoping review evaluated current evidence on the use of CCM in assessing corneal nerve fibre changes across neurodegenerative diseases (NDDs) and explored its potential as a paraclinical diagnostic and monitoring tool. A comprehensive search of PubMed and Scopus was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines to identify studies reporting quantitative CCM metrics, including corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fibre length (CNFL). Both cross-sectional and longitudinal studies of patients with NDDs were included, and findings were narratively synthesised. 50 studies were included: Parkinson's disease (n=13), multiple sclerosis (n=11), cerebrovascular accidents (n=7), post-COVID-19 neuropathy (n=5), amyotrophic lateral sclerosis (n=4), chronic inflammatory demyelinating polyneuropathy (n=4), Alzheimer's disease (n=3), Fabry disease (n=2) and neurofibromatosis type 1 (n=1). CNFL and CNFD were consistently reduced in Parkinson's disease, multiple sclerosis, cerebrovascular accidents, amyotrophic lateral sclerosis, chronic inflammatory demyelinating polyneuropathy and post-COVID-19 neuropathy, whereas CNBD results were inconsistent. The strongest evidence supported the role of CCM in Parkinson's disease and multiple sclerosis. CNFL and CNFD emerged as the most reliable CCM-derived metrics across NDDs, supporting their potential as objective biomarkers for neurodegeneration. While findings support the potential of CCM as a paraclinical diagnostic tool, methodological heterogeneity in image acquisition, analysis software and study design limited comparability. Standardised imaging and analysis protocols are needed to enable broader clinical application and validation across NDDs.
Association of high-pillow sleeping posture with intraocular pressure in patients with glaucoma.
Liu T, Hu M, Liu X … +4 more , Wang Z, Yao K, Chen M, Wang K
Br J Ophthalmol · 2026 Jan · PMID 41592946 · Publisher ↗
BACKGROUND: Intraocular pressure (IOP) exhibits significant fluctuations in response to changes in body posture. Postural modification may serve as a potential adjunctive strategy for IOP management in glaucoma patients....
BACKGROUND: Intraocular pressure (IOP) exhibits significant fluctuations in response to changes in body posture. Postural modification may serve as a potential adjunctive strategy for IOP management in glaucoma patients. METHODS: A total of 144 patients with glaucoma were enrolled in this study. IOP was measured and compared between the high-pillow position (head elevated by 20-35° using two pillows) and the supine position. Additionally, changes in jugular venous lumen in response to postural variation were evaluated via ultrasonography in 20 healthy volunteers. RESULTS: Compared with the supine position, the high-pillow position was associated with significantly elevated IOP, increased 24-hour IOP fluctuation and reduced ocular perfusion pressure (OPP) (all p<0.001). Greater postural IOP fluctuation (ΔIOP) was observed in younger individuals (p=0.027) and patients with primary open-angle glaucoma (POAG) (p<0.001). Multiple regression analysis identified thicker central corneal thickness and the presence of POAG (vs normal-tension glaucoma) as positive predictors of larger ΔIOP changes (both p<0.05). Ultrasonography in healthy volunteers revealed significant constriction of both internal and external jugular venous lumen in the high-pillow position (all p<0.001), accompanied by an increase in maximum blood flow velocity of the internal jugular vein (p=0.013). CONCLUSION: Compared with the supine position, the high-pillow position is associated with increased IOP and decreased OPP in patients with glaucoma, which may be linked to jugular venous compression. Patients with glaucoma may benefit from avoiding sleeping postures that induce jugular venous compression to mitigate postural IOP elevation, though further studies are needed to validate these preliminary associations.
Amblyopia and adult health: a comprehensive analysis of long-term systemic, sensory and mental health comorbidities in a national cohort.
Lee KAV, Langholm C, Lin T … +4 more , Jin K, Aboobakar IF, Oke I, Whitman MC
Br J Ophthalmol · 2026 Jan · PMID 41592945 · Full text
AIMS: To evaluate the adult health consequences of amblyopia, including sensory deficits, mental health, physical activity and cardiovascular health. METHODS: A cross-sectional study using data from the National Institut...
AIMS: To evaluate the adult health consequences of amblyopia, including sensory deficits, mental health, physical activity and cardiovascular health. METHODS: A cross-sectional study using data from the National Institutes of Health's Research Program, including 1998 adults with amblyopia (1335 non-strabismic, 663 strabismic) identified by International Classification of Diseases (ICD)-9/ICD-10/Systemized Nomenclature of Medicine (SNOMED) codes, including 187 with Fitbit data. Controls (10:1 ratio) were propensity-score-matched on age, sex, self-reported race, income and healthcare visits. Separate matched control groups were used for Fitbit and subgroup analyses. Data from electronic health records, surveys and Fitbit were used to assess sensory impairments, cardiometabolic conditions, physical activity and neuropsychiatric disorders. Prevalence and ORs with 95% CIs were calculated to assess associations between amblyopia (total, strabismic and non-strabismic) and health outcomes. RESULTS: Amblyopia was associated with increased odds of bilateral blindness (OR=2.96, 95% CI 2.54 to 3.44), obesity (OR=1.27, 95% CI 1.16 to 1.39), type 2 diabetes (OR=1.39, 95% CI 1.26 to 1.53) and cardiovascular disease (OR=1.92, 95% CI 1.69 to 2.19). Amblyopic individuals took fewer daily steps (5859 vs 6229; p=0.044), indicating decreased physical activity. Neuropsychiatric disorders were more common, including generalised anxiety (OR=1.57, 95% CI 1.43 to 1.72), substance use disorder (OR=1.40, 95% CI 1.25 to 1.55), bipolar disorder (OR=1.35, 95% CI 1.13 to 1.61), attention-deficit/hyperactivity disorder (OR=1.54, 95% CI 1.28 to 1.86), obsessive compulsive disorder (OR=1.82, 95% CI 1.31 to 2.54) and autism (OR=3.27, 95% CI 1.79 to 5.99). Schizophrenia was not associated (OR=1.00, 95% CI 0.70 to 1.42). CONCLUSIONS: Amblyopia is associated with long-term systemic health conditions, suggesting either long-term effects of visual impairment or shared underlying risk factors. These findings underscore the need for early detection and intervention. Further research is needed to explore the neurodevelopmental pathways linking amblyopia and its comorbidities.
Antimicrobial resistance surveillance: lessons learnt from large databases of antimicrobial resistance genes.
Shen J, Tigabu A, Mishra SK … +5 more , Urmi U, Ozkan J, Stapleton F, Yasir M, Willcox M
Br J Ophthalmol · 2026 Jan · PMID 41577432 · Publisher ↗
Ocular infections, caused by a variety of microbes, are likely to become more difficult to treat due to the global increase in antimicrobial resistance (AMR). Traditional assays for resistance only analyse a small propor...
Ocular infections, caused by a variety of microbes, are likely to become more difficult to treat due to the global increase in antimicrobial resistance (AMR). Traditional assays for resistance only analyse a small proportion of the possible resistance capability of microbes. This review discusses the use of genomic datasets for predicting AMR and their current applications in investigating ocular infections. The use of whole genome sequencing coupled with several large databases on antimicrobial resistance genes (ARGs) can predict phenotypic resistance and multidrug resistance in bacteria. Use of this technology for viral and fungal infections is less advanced and would be a useful area for future research. Metagenomic analysis of the ocular surface microbiome for ARGs could be a sensitive and rapid method for tracking resistance in ocular infections, and monitoring commensal reservoirs of transferable ARGs. Applications of these newer technologies to ocular infections also have the potential to assess the long-term impact of topical antibiotics, disinfectants and preservative use on the ocular microbiome, as well as being used in epidemiological studies to study acquisition and transmission of ARGs.
UK National Artificial Eye Questionnaire study: exploring factors influencing quality of life in cosmetic shell wearers.
Shapira Y, Worrell E, Litwin AS … +1 more , Malhotra R
Br J Ophthalmol · 2026 Jan · PMID 41558836 · Publisher ↗
PURPOSE: To identify factors associated with visual function and quality of life (QOL) in cosmetic shell (scleral shell) wearers. METHODS: This nationwide, cross-sectional, multicentre study was conducted across the Nati...
PURPOSE: To identify factors associated with visual function and quality of life (QOL) in cosmetic shell (scleral shell) wearers. METHODS: This nationwide, cross-sectional, multicentre study was conducted across the National Health Service England. Cosmetic shell wearers completed the National Artificial Eye Questionnaire, which incorporated 15 items from the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Multivariate regression assessed associations between QOL scores and patient experiences, routine care, demographics and clinical factors. RESULTS: Among 238 respondents, predictors of the QOL composite score included comfort (β=0.25, p<0.001), age 50-65 (β=-0.20, p<0.05), appearance (β=0.20, p<0.05), perceived polishing benefit (β=-0.15, p<0.05) and congenital aetiology (β=0.15, p<0.05). Comfort was positively associated with all VFQ subscales (p<0.05). Lesser discharge predicted better near vision (β=0.19), and non-visible discharge predicted better social function (β=0.14). Appearance was associated with mental health (β=0.19), role difficulties (β=0.17) and dependency (β=0.27). Motility showed no association. Age 30-50 predicted worse dependency (β=-0.18); congenital aetiology predicted better mental health (β=0.19) and cancer worse role difficulties (β=-0.16). A greater perceived polishing benefit was linked to worse role difficulties (β=-0.16) and dependency (β =-0.12). CONCLUSIONS: This is the first study to evaluate QOL predictors in cosmetic shell wearers. While some factors overlap with artificial eye users, key differences underscore the distinct needs of this group.
Rising glaucoma burden demands evidence-based strategies.
Schuster AK, Schweitzer C
Br J Ophthalmol · 2026 Jan · PMID 41558835 · Publisher ↗
Abstract loading — click title to view on PubMed.
Three-year efficacy and safety of repeated low-level red-light therapy for myopia control: a multicentre real-world study.
Chen Y, Wang W, Xiong R … +17 more , Yu F, Pan S, Dong J, Zhang J, Zhu Z, Ding X, Wang B, Chen Y, Chan HH, Choi KY, Chan SSH, Zheng Y, Shi D, Aung Y, Kishi S, Ohno-Matsui K, He M
Br J Ophthalmol · 2026 Feb · PMID 41558834 · Publisher ↗
BACKGROUND: To evaluate the efficacy and safety of repeated low-level red-light (RLRL) therapy for controlling myopia progression over 3 years in real-world settings. METHODS: This multicentre cohort study included parti...
BACKGROUND: To evaluate the efficacy and safety of repeated low-level red-light (RLRL) therapy for controlling myopia progression over 3 years in real-world settings. METHODS: This multicentre cohort study included participants currently undergoing RLRL treatment, identified from electronic medical databases in three hospitals (myopic children and adolescents aged 7-18 years, who were prescribed RLRL therapy from 1 June 2018 to 1 June 2023), using stratified random sampling based on RLRL treatment duration (≥0.5-1 year, ≥1-2 years, ≥2-3 years and ≥3 years), with approximately 90 participants in each group. All participants voluntarily received RLRL therapy twice a daily (3 min/session, ≥4-hour interval), 5-7 days/week. RESULTS: Among 362 participants, 90 were treated for ≥0.5-1 year (median 0.64 year), 91 for ≥1-2 years (median 1.40 years), 90 for ≥2-3 years (median 2.30 years) and 91 for ≥3 years (median 3.65 years). The satisfactory myopia control rate (defined as annual axial elongation ≤0.10 mm) was 72.53% (95% CI 62.17 to 81.37) over ≥3 years of RLRL treatment, with annual axial length change of 0.06 mm/year (95% CI 0.03 to 0.08). No subjective visual function damage was documented by best-corrected visual acuity, and no treatment duration-dependent changes in objective full-field electroretinogram were observed. A minimal, reversible optical coherence tomography change was noted in four eyes which did not impact visual function. CONCLUSIONS: This real-world study demonstrates that RLRL therapy provides promising long-term efficacy and safety in myopia control over 3 years among Chinese myopic children and adolescents. TRIAL REGISTRATION NUMBER: NCT05871840.
Safety profile of long-term intraocular ophthalmic viscoelastic devices: a systematic review.
Khalil R, Shah D, Sutaria A … +3 more , Luxhøj CM, Orsine Murta Dias K, Petrushkin H
Br J Ophthalmol · 2026 Jan · PMID 41558833 · Publisher ↗
PURPOSE: Since first being introduced over 50 years ago, ophthalmic viscoelastic devices (OVDs) have revolutionised the fields of cataract, cornea and glaucoma surgery, with extensive published anterior segment safety da...
PURPOSE: Since first being introduced over 50 years ago, ophthalmic viscoelastic devices (OVDs) have revolutionised the fields of cataract, cornea and glaucoma surgery, with extensive published anterior segment safety data available. More recently, these devices have also gained popularity in posterior segment surgery, with particular focus on their potential use as long-lasting, non-toxic, biocompatible and biodegradable vitreous substitutes. The most commercially available products are based on hydrophilic polymers such as hyaluronic acid (HA), hydroxypropylmethylcellulose (HPMC) and chondroitin sulfate (CS). This remains a novel area of research, with very few studies examining their long-term safety profile. METHODS: We conducted a systematic review on Medline and Embase via OVID, using key words "viscoelastics" and "intraocular". Both databases were searched from inception date, with no language limitations. RESULTS: There is a paucity of high-quality evidence addressing the long-term safety of OVDs in the eye. A total of 38 studies were included for final review. These studies were unsuitable for any direct head-to-head comparisons; therefore, a descriptive analysis is presented. CONCLUSIONS: By far, HA-based OVDs have been the most well described, with several long-term intraocular applications. They display highly favourable biophysical properties with minimal adverse reactions in short and long-term in vivo, in vitro and animal studies. There is limited safety data on HPMC and CS-based products, despite their popularity. This represents a gap in the literature and invites the need for high-quality evidence to support their continued use, particularly in the realms of vitreoretinal surgery and chronic hypotony.
Exploring iridotrabecular contact index and related factors in primary angle closure disease: a swept-source anterior segment OCT study.
Jeong Y, Park KH, Jeoung JW
Br J Ophthalmol · 2026 Jan · PMID 41558832 · Publisher ↗
BACKGROUND/AIMS: This study evaluates the relationship between the iridotrabecular contact (ITC) index and various anterior segment parameters, with a particular focus on lens-related parameters, given their clinical rel...
BACKGROUND/AIMS: This study evaluates the relationship between the iridotrabecular contact (ITC) index and various anterior segment parameters, with a particular focus on lens-related parameters, given their clinical relevance in primary angle closure disease (PACD). METHODS: A retrospective analysis was conducted on consecutive patients with PACD who underwent swept-source anterior segment optical coherence tomography (AS-OCT). All AS-OCT images were manually reviewed. Relative lens vault greater than one-third was defined as 'high vault'." The ability to detect an ITC index ≥50% was assessed using area under the receiver operating characteristic curve (AUROC). Decision tree analysis identified factors influencing the ITC index. RESULTS: A total of 376 patients were initially identified, and after applying exclusion criteria, 119 eyes of 119 PACD patients were included in the final analysis. The mean ITC index was 50.2%±30.5%, with a mean relative lens vault of 0.31±0.10. High vault was significantly associated with higher ITC index (p<0.001), and a positive correlation was observed (r=0.451, p<0.001). The angle recess area at 500 µm (ARA 500) parameter had the highest AUROC (0.983) for detecting ITC index ≥50%. Decision tree analysis identified trabecular iris space area at 500 µm and ARA 500 as key factors, but adding relative lens vault did not improve differentiation. CONCLUSIONS: A significant correlation exists between relative lens vault and the ITC index in PACD. However, lens vault does not enhance the diagnostic accuracy of angle parameters for identifying the ITC index. Comprehensive evaluation of PACD should include parameters beyond lens measurements.
Current burden and future projections of glaucoma in the United Kingdom.
Meliante LA, Stuart KV, Luben RN … +3 more , Nolan WP, Khawaja AP, Foster PJ
Br J Ophthalmol · 2026 Jan · PMID 41558831 · Publisher ↗
BACKGROUND/AIMS: Up-to-date, stratified estimates of the number of individuals affected by glaucoma in the UK are lacking. This study aimed to estimate the current and future glaucoma burden in the UK population. METHODS...
BACKGROUND/AIMS: Up-to-date, stratified estimates of the number of individuals affected by glaucoma in the UK are lacking. This study aimed to estimate the current and future glaucoma burden in the UK population. METHODS: The most recent UK census data were used to obtain population counts stratified by age, sex and ethnicity. Age and sex-specific glaucoma prevalence estimates for individuals of European ancestry were sourced from a recent individual participant data meta-analysis of the European Eye Epidemiology Consortium. For non-European ethnic groups, prevalence was estimated by applying relative risks from a Bayesian global meta-analysis to the European baseline. Population projections from the UK's Office for National Statistics were used to estimate future disease burden. RESULTS: Among 34 million UK adults aged ≥40 years, an estimated 1 019 629 individuals (95% CI 691 042 to 1 428 594) are currently living with glaucoma. Estimated age-specific case numbers increase from approximately 10 000 at ages 40-44 to nearly 173 000 in those ≥85 years. Although non-European groups represent only 5.8% of the UK population aged ≥65, they account for an estimated 8.1% of current glaucoma cases. By 2060, the number of affected individuals is projected to rise to 1.61 million (95% CI 1.11 million to 2.22 million), corresponding to a 60% rise in cases despite only a 28% population increase, driven by demographic ageing and the growth of higher-risk ethnic populations. CONCLUSION: The UK glaucoma burden is substantially higher than previously estimated and is expected to rise further by 2060, underscoring the need for targeted resource allocation and strategic healthcare planning.
Artificial intelligence-based fluid quantification predicts clinical outcomes in diabetic macular oedema eyes treated with intravitreal dexamethasone implants: DIADEMA project.
Franquesa-Garcia F, Romero-Nuñez B, Martin-Pinardel R … +20 more , De Zanet S, González-López JJ, Escobar-Barranco JJ, Ruiz-Del-Tiempo MP, Boixadera A, Fonollosa A, Gómez-Benlloch A, Velazquez-Villoria D, Fernández-Vigo JI, Garay-Aramburu G, Parrado-Carrillo A, Castillon L, Gómez Sánchez S, Lavid FJ, Arruabarrena C, Figueras-Roca M, Bernal-Morales C, Ciller C, Zarranz-Ventura J, DIADEMA investigators
Br J Ophthalmol · 2026 Jan · PMID 41545173 · Publisher ↗
AIM: To explore associations between artificial intelligence (AI)-based baseline optical coherence tomography (OCT) fluid compartment quantifications and 12-month visual outcomes in diabetic macular oedema (DME) eyes tre...
AIM: To explore associations between artificial intelligence (AI)-based baseline optical coherence tomography (OCT) fluid compartment quantifications and 12-month visual outcomes in diabetic macular oedema (DME) eyes treated with the intravitreal dexamethasone implant. METHODS: This was a multicentre, real-world, national DME database and associated OCT dataset study. Demographics, visual acuity (VA), treatments and visit data were collected using a validated web-based tool (Fight Retinal Blindness). Fluid compartment quantifications, including intraretinal fluid (IRF) and subretinal fluid (SRF), were measured in nanolitres (nL) using a validated AI tool (Discovery). Univariate and multivariate regression mixed models evaluated associations between anatomical variables and VA outcomes. RESULTS: A total of 101 treatment-naïve DME eyes were grouped into quartiles according to their fluid volume for each fluid compartment (Q1: lowest volume, Q4: highest volume). Baseline IRF was associated with greater VA gains at month 12 (+6.34 letters, p=0.07) but poorer final VA (-8.95, p=0.07), while SRF was associated with worse final VA at 12 months (-12.5, p=0.01). At month 3, IRF was associated with a VA decrease at 12 months (-13.7, p=0.02) and lower final VA (-29.8, p<0.001). At month 12, IRF was associated with lower final VA (-11.6, p=0.03). Quantitatively, a reduction of 100 nL of IRF at 3 months was associated with a +1.54 letters gain (p=0.03) in the multivariate analysis. CONCLUSION: This real-world, multicentre study describes objective baseline fluid volumes that predict visual outcomes at 12 months in routine clinical care. Accurate quantification of baseline fluid volumes may play a predictive role for final visual outcomes.
Corneal endothelial cell density changes after Preserflo MicroShunt implantation.
Baba T, Baba O, Hirose K … +4 more , Okada N, Tokumo K, Sakaguchi H, Hirooka K
Br J Ophthalmol · 2026 Jan · PMID 41545172 · Publisher ↗
AIMS: To evaluate the effect of Preserflo MicroShunt (PMS) implantation on corneal endothelial cell density (CECD) and to identify factors associated with CECD loss. METHODS: This retrospective study included patients wh...
AIMS: To evaluate the effect of Preserflo MicroShunt (PMS) implantation on corneal endothelial cell density (CECD) and to identify factors associated with CECD loss. METHODS: This retrospective study included patients who underwent PMS implantation, with or without combined cataract surgery, between March 2023 and April 2024, with a minimum of 12 months of postoperative follow-up. CECD was measured preoperatively and at 3, 6 and 12 months postoperatively. The primary outcome was the change in CECD after PMS implantation. Secondary analyses included linear regression to estimate annual CECD loss and logistic regression to identify factors associated with CECD reduction. RESULTS: In total, 104 eyes (70 PMS alone, 34 combined with phacoemulsification) were included. Mean CECD (cells/mm²) in PMS-alone group and combined-with-phacoemulsification group were 2312.9±501.7 and 2615.0±365.5 at baseline, 2253.7±530.9 and 2354.4±424.6 at 3 months postoperatively, 2234.6±528.5 and 2374.6±458.9 at 6 months postoperatively and 2149.2±537.5 and 2357.6±508.7 at 12 months postoperatively, respectively. The estimated annual CECD loss was 7.3±11.9% in the PMS-alone group and 8.0±17.2% in the combined-with-phacoemulsification group (p=0.47). Multivariate logistic regression revealed that a narrower tube-cornea angle (TCA) (p=0.01) and higher preoperative IOP (p=0.04) were significantly associated with greater CECD loss. CONCLUSIONS: PMS implantation was associated with CECD reduction over 12 months. A narrower TCA and higher preoperative intraocular pressure were significant predictors of CECD loss.
Correction: .
Br J Ophthalmol · 2026 Feb · PMID 41535099 · Full text
Abstract loading — click title to view on PubMed.
Orbital inflammation in VEXAS syndrome.
Quigley C, Pietris J, Ang T … +21 more , Al Mater A, Beecher M, Oh A, Rootman DB, Theis NJ, Weatherhead R, Ferguson R, Ng S, Botha V, Ong RM, Davies MJ, Kalapesi F, Osborne SF, Vahdani K, Rasmussen MLR, Heegaard S, Sales-Sanz M, González-García A, Sullivan TJ, Wang DD, Selva D
Br J Ophthalmol · 2026 Jan · PMID 41535098 · Publisher ↗
INTRODUCTION: Vacuoles, E1-ligase, X-linked Auto-inflammatory, Somatic (VEXAS) syndrome is a recently described multisystem inflammatory disorder. Ocular features are described, though not well known; we aimed to describ...
INTRODUCTION: Vacuoles, E1-ligase, X-linked Auto-inflammatory, Somatic (VEXAS) syndrome is a recently described multisystem inflammatory disorder. Ocular features are described, though not well known; we aimed to describe them. METHODS: This is a case series of VEXAS patients submitted by ophthalmologists from relevant specialty organisations, including the Australian and New Zealand Society of Ophthalmic Plastic Surgeons, British Oculoplastic Surgical Society and the Orbital Society. Patient consent was received. RESULTS: 14 males with VEXAS syndrome and eye features were included, median age 73 years (range 49-78). The associated mutation was most commonly p.Met41Val (n=8, 57%), and most patients were Caucasian (n=11, 79%). All patients reported eyelid swelling (n=14, 100%); the next most frequent symptom was eye pain (n=10, 71%). Eye symptoms showed variable duration at presentation, most commonly 2-7 days (n=6, 43%). Eye involvement was typically bilateral (metachronous n=5, 36%, synchronous n=2, 14%). Overall, visual acuity was normal and did not change. Severe vision loss occurred unilaterally in two patients (14%), due to orbital compartment syndrome and periorbital necrotising fasciitis. Ophthalmologist-reported clinical features included periorbital oedema, present in all cases (n=14, 100%), followed by dacryoadenitis (n=8, 57%) and orbital myositis (n=7, 50%). There were no cases of posterior segment inflammation. Death due to complications of VEXAS occurred in one patient (7%). CONCLUSION: Orbital inflammation was a feature in all cases of VEXAS with eye involvement, and severe loss of vision occurred unilaterally in 14%. Ocular complaints in VEXAS patients should prompt urgent ophthalmic assessment.
Advanced analysis of leading large language models for diagnostic accuracy in retinal imaging.
Carlà MM, Crincoli E, Catania F … +6 more , De Luca L, Giannuzzi F, Boselli F, Gambini G, Mateo C, Rizzo S
Br J Ophthalmol · 2026 Jan · PMID 41535097 · Publisher ↗
BACKGROUND/AIMS: To evaluate and compare the diagnostic capabilities of advanced large language models (LLMs) in interpreting ophthalmological fundus images across diverse pathologies. METHODS: We evaluated eight leading...
BACKGROUND/AIMS: To evaluate and compare the diagnostic capabilities of advanced large language models (LLMs) in interpreting ophthalmological fundus images across diverse pathologies. METHODS: We evaluated eight leading multimodal LLMs (GPT-4.5, Claude 3.7 Sonnet, Grok-2, Deepseek Cognition V2, Qwen2 72B, Gemini 2.0 Pro, Llama 3 405B and Mixtral 8×22B) on their ability to interpret 100 fundus images representing various ophthalmological conditions. Performance was assessed using validated charts for diagnostic accuracy, specificity, sensitivity, consistency, relevance and explanation quality. RESULTS: GPT-4.5 achieved the highest overall diagnostic accuracy (65.0%), followed by Gemini 2.0 Pro (63.0%). All models showed varied performance across pathology categories, with rhegmatogenous pathologies being most accurately identified (Gemini 2.0 Pro: 81.3%, GPT-4.5: 75.0%) and myopic maculopathy (mean accuracy 21.8%) being particularly challenging. The remaining models performed significantly worse: Deepseek Cognition V2 (52.0%), Claude 3.7 Sonnet (52.0%), Qwen2 72B (49.0%), Llama 3 405B (48.0%), Grok-2 (47.0%) and Mixtral 8×22B (46.0%). Lower-performing models frequently declined to provide diagnoses, with refusal rates from 8.0% (Claude 3.7 Sonnet) to 19.0% (Mixtral 8×22B). CONCLUSION: Current LLMs show promising but limited capabilities in ophthalmological image interpretation. While performance on common conditions like retinal detachments and age-related macular degeneration is moderately good, significant challenges remain with rare conditions, myopic pathologies and complex vascular disorders. The competitive performance between GPT-4.5 and Gemini 2.0 Pro, with each excelling in different pathology categories, suggests that leveraging their complementary strengths might offer improved diagnostic support.
Cycloplegic autorefraction doubles diagnostic yield of myopia compared to vision testing: findings from a decade-long screening programme.
Wang CY, Yang YC, Yang HY … +7 more , Fang SY, Shyong MP, Lee CW, Huang PW, Chen YL, Hsu NW, Tsai DC
Br J Ophthalmol · 2026 Jan · PMID 41529935 · Publisher ↗
BACKGROUND: Cycloplegic autorefraction may offer higher diagnostic accuracy than uncorrected visual acuity (VA) screening. We aimed to evaluate diagnostic yield and risk factors for previously unrecognised myopia. METHOD...
BACKGROUND: Cycloplegic autorefraction may offer higher diagnostic accuracy than uncorrected visual acuity (VA) screening. We aimed to evaluate diagnostic yield and risk factors for previously unrecognised myopia. METHODS: This repeated cross-sectional study analysed data from 33 642 kindergarteners aged 5-6 years enrolled in the Yilan Myopia Prevention and Vision Improvement Program from 2014 to 2024. Participants underwent uncorrected VA testing and on-site cycloplegic autorefraction. Caregivers completed questionnaires on myopia-related behaviours. Previously unrecognised or newly detected myopia (NDM), defined as spherical equivalent ≤-0.50 dioptres without prior diagnosis. The main outcome was diagnostic yield, defined as the proportion of NDM among at-risk participants by different screening methods. RESULTS: Among 33 642 participants (mean age, 5.23±0.41 years; 51.7% boys), 3206 (9.5%) were identified myopic, including 2303 (6.8%) who were newly detected through cycloplegic autorefraction, yielding a diagnostic rate of 7.03% (95% CI 6.76% to 7.32%). Only 47.9% children with NDM met the reduced VA referral criterion (uncorrected VA <6/7.5 in either eye), and the diagnostic yield of VA screening was 3.37% (95% CI 3.18% to 3.57%; area under the ROC curve: 0.743). NDM was significantly associated with weekend behaviours including digital screen time ≥2 hours/day (OR, 1.13; 95% CI 1.03 to 1.23) and outdoor time ≥2 hours/day (OR, 0.85; 95% CI 0.78 to 0.94). In contrast, previously detected myopia showed no association with these modifiable factors. CONCLUSIONS: Preschool myopia screening using cycloplegic autorefraction significantly improves early detection compared with VA screening. Timely diagnosis raises parental awareness and empowers children to modify myopia-related behaviours.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe