Intracellular dark endothelial spots (IDESs) on specular microscopy developed in 78/122 patients (63.9%) after Descemet stripping automated endothelial keratoplasty (DSAEK). Endothelial cell density (ECD) after DSAEK was significantly smaller in eyes with IDES when compared with those without at all time points (p<0.001) despite no significant difference in graft ECD (p=0.43), resulting in an increased

Objective To evaluate nyctohemeral effects of topical beta-adrenoceptor blocking agents and their fixed combinations on intraocular pressure (IOP) in patients with primary open-angle glaucoma implanted with an ocular telemetry sensor. Methods 22 patients who had previously been implanted with a sulcus-based IOP sensor (eyemate) were included in this prospective clinical trial. Three classes of medications

Background This study aimed to characterise imaging artefacts in the lacrimal gland using swept-source optical coherence tomography (SS-OCT) in patients with dry eye disease (DED) and healthy participants and identify risk factors for these artefacts. Methods In total, 151 eyes, including 104 from patients with DED and 47 from non-DED participants, were analysed. Demographic data collection, comprehensive

Background Non-infectious uveitis is a diverse group of inflammatory conditions that collectively account for substantial blindness worldwide. Expert guidelines and results of clinical trials guide treatment, but real-world clinical care is impacted by additional factors. In 2023, an international group of uveitis-specialised ophthalmologists formed the International Study Group for Systemic Immunomodulatory

Background/ Aims The lack of context for anterior segment optical coherence tomography (ASOCT) measurements impedes its clinical utility. We established the normative distribution of anterior chamber depth (ACD), area (ACA) and width (ACW) and lens vault (LV), and applied percentile cut-offs to detect primary angle closure disease (PACD; ≥180° posterior trabecular meshwork occluded). Methods We included

Background/aims To examine longitudinal optical coherence tomography angiography (OCTA) changes in macula and optic nerve head (ONH) in healthy, glaucoma suspect (GS) and primary open-angle glaucoma (POAG) eyes. Methods Healthy, GS and POAG eyes from Diagnostic Innovations in Glaucoma Study with ≥2 years follow-up and four visits of macular/ONH OCTA imaging were included. Rates of macular wiVD (whole-image

Aims To investigate the impact of surgeon learning on endothelial keratoplasty (EK) procedure outcomes. Methods A prospective nationwide registry study of EK grafts in patients aged at least 21 years with Fuchs endothelial corneal dystrophy or pseudophakic bullous keratopathy undergoing a first EK procedure in that eye between 2005 and 2020. EK procedures were either Descemet Stripping Endothelial

Shunmugaranjan et al report that surgical experience is strongly associated with better outcomes after endothelial transplantation.1 The authors used prospective national registry data from over 11 000 endothelial keratoplasties, including Descemet stripping (automated) endothelial keratoplasty (DSEK/DSAEK) or Descemet membrane endothelial keratoplasty (DMEK) to evaluate the impact of surgeon experience

Aim The aim is to compare the efficacy and safety of three different weight-adjusted intravenous erythropoietin (EPO) doses in patients with indirect traumatic optic neuropathy (TON). Methods This study is a multicentre, randomised, parallel-group, double-blind, dose-finding trial on patients aged ≥7 years with a confirmed diagnosis of indirect TON in ≤3 weeks. The trial had a 3-day treatment period

In patients with keratoconus, the classification of the severity stage assessed by anterior segment optical coherence tomography was a reliable predictor for success in big bubble formation during deep anterior lamellar keratoplasty. This study adds to existing evidence that unilateral corneal disease or surgical trauma can affect the homeostasis of the contralateral cornea. In this study, significant

The recent publication by Lucchino et al reports on preoperative predictive factors for big bubble (BB) formation during deep anterior lamellar keratoplasty (DALK) in keratoconus eyes.1 In a total of 140 eyes of 140 patients, the authors observed successful pneumatic dissection in 98 eyes (70.0%), with 94 type 1 BB (67.1%) and 4 type 2 BB (2.9%). The study provides topographic evidence for a higher

Functional vision disorder (FVD) is a relatively common diagnosis in ophthalmic practice which can be difficult to make because of clinician’s apprehension to miss organic pathology. We review the diagnostic approach to patients with FVD, organic mimics of FVD, its diagnostic and management strategies and associated cost burden. Patients with FVD typically present with visual acuity and/or field loss

Purpose To identify preoperative predictors of big bubble (BB) formation during deep anterior lamellar keratoplasty (DALK) in patients with keratoconus (KC). Design Retrospective cohort study in an Italian tertiary centre. Study population Consecutive patients with KC undergoing DALK from January 2021 to July 2023. Observation procedure Tomographic and topographic data including K-max, K-mean, keratometric

Aims To evaluate the bilateral changes in the sub-basal nerve plexus of the cornea and ocular surface function after unilateral small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (tPRK) procedures. Methods 34 patients were enrolled in the study and underwent unilateral SMILE (21 of 34 patients) or unilateral tPRK (13 of 34 patients). Complete ophthalmic examinations

Aims To assess the impact of dry eye symptoms (DESs) on health-related quality of life (HRQOL) among Chinese residents. Methods A total of 21 916 participants were involved in this nationwide cross-sectional study. All of them completed the Ocular Surface Disease Index-6 and the five-level European Quality of Life 5-Dimensional (EQ-5D) Questionnaire to assess the severity of DES and HRQOL, respectively

Purpose To compare the effectiveness and efficiency of a glued (sutureless) technique for amniotic membrane transplantation (AMT) with a traditional sutured one in the setting of acute Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Methods This retrospective cohort study evaluated all patients diagnosed with SJS/TEN between 2008 and 2020 within our hospital network who received AMT

Background/aims To propose an approach to determine the target ratio of cataract surgical rates (CSRs) of female to male subpopulations to increase sex parity in cataract surgical coverage (CSC), based on the sex gap in cataract burden and incidence, and demonstrate its application to Theni district, India. Methods A population-based longitudinal study between January 2016 and April 2018. We recruited

Aims To assess the safety of femtosecond laser-assisted cataract surgery (FLACS) based on surgical parameters and intraoperative complications analysis and to determine the length of the learning curve for FLACS. Methods A prospective consecutive cohort study was conducted on Chinese patients who underwent either FLACS (3289 cases) or contemporaneous conventional phacoemulsification cataract surgery

Background Intraocular pressure (IOP) monitoring in glaucoma management is evolving with novel devices. We investigated the reproducibility of 24 hour profiles on two consecutive days and after 30 days of self-measurements via telemetric IOP monitoring. Methods Seven primary patients with open-angle glaucoma previously implanted with a telemetric IOP sensor in one eye underwent automatic measurements

Aims To investigate the physiological nyctohemeral intraocular pressure (IOP) rhythms of normal Chinese adults using a novel contact lens sensor system (CLS) that can output IOP in millimetres of mercury (mm Hg) continuously. Methods Fifty-nine eyes of 59 normal Chinese adults completed 24-hour IOP monitoring using the novel CLS. A descriptive analysis was conducted on the 24-hour IOP mean, peak and

Background Birdshot chorioretinitis (BSCR) is a chronic bilateral posterior uveitis, which can affect central as well as peripheral vision. The aim of this study was to assess how visual acuity and visual field evolved over time in patients with BSCR. Methods This was a prospective, observational, single-centre study based on data from the CO-BIRD cohort. Patient visits were categorised based on the

Background/aims Ocular manifestations of histiocytosis and their genetic underpinnings are poorly characterised. This study characterises ocular sites of histiocytosis, notate genetic alterations and correlates to histiocytosis clinical features including subtype and sites of disease. Methods Prospective registry-based study of predominantly adult histiocytosis patients at a single-institution tertiary

Aims To develop and externally test deep learning (DL) models for assessing the image quality of three-dimensional (3D) macular scans from Cirrus and Spectralis optical coherence tomography devices. Methods We retrospectively collected two data sets including 2277 Cirrus 3D scans and 1557 Spectralis 3D scans, respectively, for training (70%), fine-tuning (10%) and internal validation (20%) from electronic

Aims Choroidal neovascularisation (CNV) in patients with X-linked retinoschisis (XLRS) has been poorly documented. This study aims to investigate the prevalence and clinical characteristics of CNV in patients with XLRS, as well as analyse the preliminary genotype–phenotype correlation. Methods A retrospective case series of patients with genetically confirmed XLRS was included. Demographic, clinical

Aims To describe the clinical features, multimodal imaging, treatments and natural course of acute spontaneous vortex vein occlusion. Methods Clinical data were collected on nine patients with acute vortex vein occlusion. The symptoms and signs, multimodal imaging, treatments and follow-up results were summarised. Results Six patients (66.7%) were men and three (33.3%) were women. The mean age was

Aims To examine differences between the eyes in choriocapillaris perfusion and choroidal thickness in children with myopic anisometropia. Methods In this observational and prospective study, 46 children with myopic anisometropia were enrolled. Choriocapillaris perfusion parameters, including the percentage of flow voids, the total number of flow voids and the average flow void area were obtained by

Aims To report the 1-year results of the efficacy of a defocus distributed multipoint (DDM) lens in controlling myopia progression in a multicentre, randomised controlled trial. Methods Overall, 168 children aged 6–13 years were recruited and randomly assigned to wear a DDM lens (n=84) or single-vision (SV) lens (n=84) in three centres. Cycloplegic autorefraction (spherical equivalent refraction (SER))

Aim The purpose of this study was to assess the prevalence of strabismus and nystagmus and to analyse associated factors in preterm and full-term infants in adulthood. Methods The Gutenberg Prematurity Eye Study is a retrospective cohort study with a prospective ophthalmological examination of participants born preterm and full-term (aged 18–52 years). Perinatal data were carefully assessed for risk

To develop a predictive model for the diagnosis of iris melanoma. Methods Retrospective consecutive case series that included 100 cases of pathologically confirmed iris melanoma and 112 cases of Iris naevus, either pathological confirmation or documented stability of >1 year. Patient demographic data, features of clinical presentation, tumour characteristics and follow-up were collected. Iris melanoma

Background Cataract, glaucoma and age-related macular degeneration (AMD) are major causes of visual impairment. As these are age-related conditions, the prevalence of associated visual impairment is anticipated to increase as the population ages. However, age–period–cohort effects on the disease burden have not been investigated. Methods This was a population-based study using aggregated data from

Background To develop and assess the usability of a smartphone-based visual acuity (VA) test with an automatic distance calibration (ADC) function, the iOS version of WHOeyes. Methods The WHOeyes was an upgraded version with a distinct feature of ADC of an existing validated VA testing app called V@home. Three groups of Chinese participants with different ages (≤20, 20–40, >40 years) were recruited

Although uveitis after vaccination is rare, reports emerged during the COVID-19 pandemic. We used the pharmacovigilance case/non-case study from 1967 to 2023 to assess the association between vaccines and uveitis. We identified a significant signal for uveitis (reporting OR (ROR), 1.64; information component (IC)025, 0.66) with 1508 reports. This association is pronounced in females of all ages after

Purpose To evaluate the associations of single-nucleotide polymorphisms (SNPs) in the high-temperature requirement protease A 1 ( HTRA1) gene with myopia. Methods 25 SNPs in HTRA1 were selected, including 23 haplotype-tagging SNPs, SNP rs2142308 from a previous genome-wide association study (GWAS) of myopia and rs11200638, a SNP strongly associated with age-related macular degeneration (AMD). All SNPs

Purpose To evaluate the accuracy of current intraocular lens (IOL) formulas and identify factors influencing mean error in eyes undergoing Descemet membrane endothelial keratoplasty (DMEK) triple procedure, that is, DMEK combined with cataract extraction and IOL placement for concurrent Fuchs endothelial corneal dystrophy (FECD) and cataracts. Design Retrospective cohort study. Subjects 90 eyes with

Aims To investigate the significance of regulatory T cells (Tregs) and programmed cell death 1 (PD-1)+ cytotoxic T lymphocytes (CTLs) in the vitreous of patients with vitreoretinal lymphoma (VRL) and uveitis. Methods This study involved 51 patients with VRL and uveitis, 15 males and 36 females (mean age: 72 years, range: 51–86 years), who underwent vitrectomy at the Department of Ophthalmology, Kyoto

Background/aims To determine if patients with vitreoretinal lymphoma (VRL) and concomitant central nervous system lymphoma (CNSL) may present without brain MRI findings, but possess cerebrospinal fluid (CSF) suspicious for lymphoma. Methods This was a retrospective, single-centre, observational study evaluating patients with a diagnosis or suspicion of VRL seen at Memorial Sloan Kettering Cancer Center

Aim To employ ultrawide field three-dimensional swept-source optical coherence tomographic angiography (UWF 3D SS-OCTA) modality, integrating novel strategies, posterior eye curvature maps and posterior eye height maps, in characterising the features and disease associations of posterior staphyloma in paediatric patients. This study seeks to compare paediatric staphylomas to established adult classifications

Background/aims The aims of this study is to evaluate the anatomic, visual outcomes and associated prognostic factors in patients with advanced retinopathy of prematurity (ROP) following vitrectomy. Methods A retrospective cohort study of patients with ROP who underwent vitrectomy from 2005 to 2016 was conducted. All the patients had a follow-up period of at least 5 years. Univariate and multivariable

Aims To evaluate the visual function and foveal architecture in patients with stage 3 idiopathic epiretinal membrane (iERM). Methods A cross-sectional observational study included 56 eyes of 52 patients with stage 3 iERM. The patients were classified into type A ectopic inner foveal layers (EIFL) and type B EIFL based on the presence of a continuous hyporeflective band. Visual function and foveal microarchitecture

Aims To analyse the correlation between the physician categories defined by the 3C classification (crystal-complication-compliance) and the ocular manifestations of nephropathic cystinosis. Methods The last visit data of 64 patients aged between 2 and 64 attending the centre for management of cystinosis were reviewed. Each patient had been placed into one of four categories by the clinician based on

Background The purpose of this study was to report the incidence, time after inciting event, aetiology and risk after specific intraocular procedures and the visual outcomes associated with sympathetic ophthalmia (SO) occurrence. Methods This study reports data from multiple retrospective cohorts: retrospective population-based data were extracted from the TRICARE service network (between 2017 and

Background/aims We evaluated longitudinal autoantibody changes after intravenous methylprednisolone (IVMP), compared them with those in untreated patients and identified prognostic factors for treatment response. Methods In this single-centre, retrospective, observational study, a total of 163 individuals diagnosed with moderate-to-severe thyroid eye disease were enrolled and followed for 12 months

Aims To quantitatively measure retinal curvature (RC) in children with myopia and explore its association with refractive status. Methods This cross-sectional study included participants aged 5–18 years who underwent comprehensive ocular examinations, including cycloplegic refraction and macula 24×20 mm optical coherence tomography (OCT) scans. RC was derived from OCT data using a three-dimensional

Aims The relationship between retinal electrophysiological function and myopia progression was evaluated in school-aged children wearing Breath-O-Correct Orthokeratology (OK) lenses compared with those wearing single vision (SV) lenses over 24 months. Methods In this randomised, single-blind, parallel controlled trial, children aged 8–12 years with −1.00 to −4.00 D of myopia were recruited. Retinal

Aims To investigate the associations of genetic variants previously linked to axial length (AL) and spherical equivalent refraction (SE) in adults with refractive error and related endophenotypes in children, at baseline and 3-year follow-up. Methods 15 candidate single-nucleotide polymorphisms (SNPs), selected from previous Genome-Wide Association Studies and meta-analyses, were genotyped in 2819

Wu M, Xiong H, Xu Y, et al . Association between VEGF-A and VEGFR-2 polymorphisms …

Purpose To explore the prevalence and associated factors of parapapillary scleral ridges (PSRs). Methods Out of the cohort of the population-based Beijing Eye Study (n=3468 participants), the study included all eyes with an axial length of ≥25 mm and a randomised sample of eyes with an axial length of <25 mm. Using optical coherence tomographic (OCT) images and fundus photographs, we examined the presence

Background Myopia is a pervasive global public health concern, particularly among the younger population. However, the escalating prevalence of myopia remains uncertain. Hence, our research aims to ascertain the global and regional prevalence of myopia, along with its occurrence within specific demographic groups. Methods An exhaustive literature search was performed on several databases covering the

Purpose To compare outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) over a 12-month period with trabeculectomy in patients with advanced pigmentary glaucoma (PG). Methods This was a pilot randomised controlled trial of patients with advanced PG (mean deviation worse than −12 dB), undergoing either GATT or a fornix-based trabeculectomy. Absolute success (criterion A) was defined as

The large language model Generative Pre-trained Transformer 4 (GPT-4, Open AI) demonstrated strong performance in answering simulated ophthalmology board-style examination questions, surpassing its predecessor GPT-3.5. ChatGPT, an AI model, outperformed human candidates and Google’s Bard in a Part 1 FRCOphth multiple choice question examination, highlighting both AI’s potential in medical education

Ophthalmology has been at the forefront of research on artificial intelligence (AI) in medicine. To some extent, this is due to the transparency of eye structures and the feasibility of detailed imaging, which lends itself to data extraction and high-quality databanks of digital images. Nor is that all: another reason for the pre-eminence of ophthalmology in AI research is the potential use of data

The rapid advancements in generative artificial intelligence are set to significantly influence the medical sector, particularly ophthalmology. Generative adversarial networks and diffusion models enable the creation of synthetic images, aiding the development of deep learning models tailored for specific imaging tasks. Additionally, the advent of multimodal foundational models, capable of generating

Foundation models represent a paradigm shift in artificial intelligence (AI), evolving from narrow models designed for specific tasks to versatile, generalisable models adaptable to a myriad of diverse applications. Ophthalmology as a specialty has the potential to act as an exemplar for other medical specialties, offering a blueprint for integrating foundation models broadly into clinical practice

As the healthcare community increasingly harnesses the power of generative artificial intelligence (AI), critical issues of security, privacy and regulation take centre stage. In this paper, we explore the security and privacy risks of generative AI from model-level and data-level perspectives. Moreover, we elucidate the potential consequences and case studies within the domain of ophthalmology. Model-level

Foundation models are the next generation of artificial intelligence that has the potential to provide novel use cases for healthcare. Large language models (LLMs), a type of foundation model, are capable of language comprehension and the ability to generate human-like text. Researchers and developers have been tuning LLMs to optimise their performance in specific tasks, such as medical challenge problems

Background Large language models (LLMs) are fast emerging as potent tools in healthcare, including ophthalmology. This systematic review offers a twofold contribution: it summarises current trends in ophthalmology-related LLM research and projects future directions for this burgeoning field. Methods We systematically searched across various databases (PubMed, Europe PMC, Scopus and Web of Science)

Background Evidence on the performance of Generative Pre-trained Transformer 4 (GPT-4), a large language model (LLM), in the ophthalmology question-answering domain is needed. Methods We tested GPT-4 on two 260-question multiple choice question sets from the Basic and Clinical Science Course (BCSC) Self-Assessment Program and the OphthoQuestions question banks. We compared the accuracy of GPT-4 models

Background Chat Generative Pre-trained Transformer (ChatGPT), a large language model by OpenAI, and Bard, Google’s artificial intelligence (AI) chatbot, have been evaluated in various contexts. This study aims to assess these models’ proficiency in the part 1 Fellowship of the Royal College of Ophthalmologists (FRCOphth) Multiple Choice Question (MCQ) examination, highlighting their potential in medical

Purpose To evaluate the capabilities and incapabilities of a GPT-4V(ision)-based chatbot in interpreting ocular multimodal images. Methods We developed a digital ophthalmologist app using GPT-4V and evaluated its performance with a dataset (60 images, 60 ophthalmic conditions, 6 modalities) that included slit-lamp, scanning laser ophthalmoscopy, fundus photography of the posterior pole (FPP), optical

Background Large language models (LLMs), such as ChatGPT, have considerable implications for various medical applications. However, ChatGPT’s training primarily draws from English-centric internet data and is not tailored explicitly to the medical domain. Thus, an ophthalmic LLM in Chinese is clinically essential for both healthcare providers and patients in mainland China. Methods We developed an