{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:34:59Z","timestamp":1785522899728,"version":"3.56.0"},"reference-count":36,"publisher":"BMJ","funder":[{"name":"Hospital-Local Government Cooperation Project of Xuhui District","award":["25XHYD-26"],"award-info":[{"award-number":["25XHYD-26"]}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2502800, 2024YFC2510800"],"award-info":[{"award-number":["2022YFC2502800, 2024YFC2510800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical Research Plan of Shanghai Shenkang Hospital Development Center","award":["SHDC12026129"],"award-info":[{"award-number":["SHDC12026129"]}]},{"DOI":"10.13039\/501100003399","name":"Shanghai Science and Technology Commission","doi-asserted-by":"crossref","award":["23Y11909800"],"award-info":[{"award-number":["23Y11909800"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271069, 82371040, 82122017, 81870642, 81970780,"],"award-info":[{"award-number":["82271069, 82371040, 82122017, 81870642, 81970780,"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["2024ZZ1025, 20244Z0015, and 20254Y0085"],"award-info":[{"award-number":["2024ZZ1025, 20244Z0015, and 20254Y0085"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,7,17]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Retinal degenerative diseases, including myopic macular degeneration (MMD) and retinitis pigmentosa (RP), lead to irreversible vision impairment, with limited treatment options. Transcranial magnetic stimulation (TMS), a non-invasive brain stimulation technique for rehabilitation, may hold potential for vision restoration. The pilot study explored whether TMS is associated with short-term functional visual improvements in patients with severe retinal degenerative diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, non-randomised, parallel-arm pilot study enrolled 98 patients with bilateral severe MMD or RP. Participants received either five consecutive days of theta-burst TMS or conventional conservative care. Primary outcomes were changes in best-corrected visual acuity (BCVA) and visual field from baseline to 4-week follow-up. Contrast sensitivity, macular sensitivity, fixation stability, Visual Function Index-14 (VF-14) and Visual Functioning Questionnaire-25 (VFQ-25) questionnaires were also evaluated. A subset of participants underwent resting-state functional magnetic resonance imaging (fMRI) to explore cortical functional changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study analysed 174 eyes from 88 patients (mean age: 60.3\u00b19.1 years; 52% female). Compared with controls, the TMS group showed greater improvements in BCVA (MMD: 0.22\u00b10.28 logarithm of the minimum angle of resolution (logMAR); RP: 0.24\u00b10.21 logMAR) and VF mean defect (MMD: 1.96\u00b12.09\u2009dB; RP: 1.08\u00b11.28\u2009dB). Contrast sensitivity, macular sensitivity and fixation stability also showed short-term gains. Patient-reported outcomes improved in several functional domains. fMRI demonstrated increased activity and functional connectivity in visual-related cortical regions following TMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this exploratory pilot study, TMS treatment was associated with short-term functional visual improvements and cortical modulation in individuals with severe retinal degenerative diseases. These findings are hypothesis-generating and warrant validation through larger, randomised, masked clinical trials with longer follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-329114","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:20:26Z","timestamp":1785518426000},"page":"bjo-2025-329114","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transcranial magnetic stimulation as a novel therapeutic approach for severe retinal degenerative diseases: a pilot study"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct06612190","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Jiaqi","family":"Meng","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4309-3871","authenticated-orcid":false,"given":"Yinglei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujun","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1629-3229","authenticated-orcid":false,"given":"Kaiwen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenwen","family":"He","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keke","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5910-8866","authenticated-orcid":false,"given":"Yi","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5588-1667","authenticated-orcid":false,"given":"Xiangjia","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"},{"name":"State Key Laboratory of Brain Function and Disorders, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"2026073110201830000_bjo-2025-329114v1.1","doi-asserted-by":"crossref","first-page":"105895","DOI":"10.1016\/j.archger.2025.105895","article-title":"Enhancing vision and well-being: eyewear design opportunities for older adults","volume":"136","author":"Hung","year":"2025","journal-title":"Arch Gerontol Geriatr"},{"key":"2026073110201830000_bjo-2025-329114v1.2","first-page":"e144","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study","volume":"9","year":"2019","journal-title":"Lancet Glob Health"},{"key":"2026073110201830000_bjo-2025-329114v1.3","doi-asserted-by":"crossref","first-page":"953","DOI":"10.2147\/OPTH.S442430","article-title":"The Underutilization of Mental Health Care Services in the Lives of People with Blindness or Visual Impairment: A Literature Review on Rehabilitation Factors Toward Provision","volume":"18","author":"Richardson","year":"2024","journal-title":"Clin Ophthalmol"},{"key":"2026073110201830000_bjo-2025-329114v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2017.02.016"},{"key":"2026073110201830000_bjo-2025-329114v1.5","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1001\/jamaophthalmol.2023.6319","article-title":"Four-Year Progression of Myopic Maculopathy in Children and Adolescents With High Myopia","volume":"142","author":"Jiang","year":"2024","journal-title":"JAMA Ophthalmol"},{"key":"2026073110201830000_bjo-2025-329114v1.6","doi-asserted-by":"publisher","DOI":"10.1038\/nrg2717"},{"key":"2026073110201830000_bjo-2025-329114v1.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2021.100975"},{"key":"2026073110201830000_bjo-2025-329114v1.8","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2017-311266"},{"key":"2026073110201830000_bjo-2025-329114v1.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.01.006"},{"key":"2026073110201830000_bjo-2025-329114v1.10","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.61.4.14","article-title":"Six-Year Changes in Myopic Macular Degeneration in Adults of the Singapore Epidemiology of Eye Diseases Study","volume":"61","author":"Wong","year":"2020","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2026073110201830000_bjo-2025-329114v1.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2018.03.005"},{"key":"2026073110201830000_bjo-2025-329114v1.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2020.100861"},{"key":"2026073110201830000_bjo-2025-329114v1.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69740-7"},{"key":"2026073110201830000_bjo-2025-329114v1.14","doi-asserted-by":"crossref","DOI":"10.1167\/tvst.8.6.45","article-title":"Chromatic Full-Field Stimulus Threshold and Pupillography as Functional Markers for Late-Stage, Early-Onset Retinitis Pigmentosa Caused by CRB1 Mutations","volume":"8","author":"Stingl","year":"2019","journal-title":"Transl Vis Sci Technol"},{"key":"2026073110201830000_bjo-2025-329114v1.15","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1038\/eye.2016.286","article-title":"Effectiveness and safety of nutritional supplements in the treatment of hereditary retinal dystrophies: a systematic review","volume":"31","author":"Brito-Garc\u00eda","year":"2017","journal-title":"Eye (Lond)"},{"key":"2026073110201830000_bjo-2025-329114v1.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1608368"},{"key":"2026073110201830000_bjo-2025-329114v1.17","doi-asserted-by":"crossref","first-page":"903","DOI":"10.3390\/biom14080903","article-title":"Gene Therapy for Retinitis Pigmentosa: Current Challenges and New Progress","volume":"14","author":"Liu","year":"2024","journal-title":"Biomolecules"},{"key":"2026073110201830000_bjo-2025-329114v1.18","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2014.2300164"},{"key":"2026073110201830000_bjo-2025-329114v1.19","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(18)30295-2"},{"key":"2026073110201830000_bjo-2025-329114v1.20","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1016\/j.brs.2022.08.016","article-title":"A differential effect of visual cortex tDCS on reading of English and Chinese in patients with central vision loss","volume":"15","author":"Silva","year":"2022","journal-title":"Brain Stimul"},{"key":"2026073110201830000_bjo-2025-329114v1.21","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.brs.2013.04.002","article-title":"Long lasting effects of daily theta burst rTMS sessions in the human amblyopic cortex","volume":"6","author":"Clavagnier","year":"2013","journal-title":"Brain Stimul"},{"key":"2026073110201830000_bjo-2025-329114v1.22","first-page":"199","article-title":"Navigated perilesional transcranial magnetic stimulation can improve post-stroke visual field defect: A double-blind sham-controlled study","volume":"39","author":"El Nahas","year":"2021","journal-title":"Restor Neurol Neurosci"},{"key":"2026073110201830000_bjo-2025-329114v1.23","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1080\/08164622.2024.2349565","article-title":"Non-invasive brain stimulation and vision rehabilitation: a clinical perspective","volume":"107","author":"Park","year":"2024","journal-title":"Clin Exp Optom"},{"key":"2026073110201830000_bjo-2025-329114v1.24","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2551"},{"key":"2026073110201830000_bjo-2025-329114v1.25","doi-asserted-by":"crossref","first-page":"825204","DOI":"10.3389\/fnagi.2022.825204","article-title":"Visual task-related functional and structural magnetic resonance imaging for the objective quantitation of visual function in patients with advanced retinitis pigmentosa","volume":"14","author":"Wang","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"2026073110201830000_bjo-2025-329114v1.26","doi-asserted-by":"crossref","DOI":"10.3389\/fnins.2023.1126262","article-title":"Exploration of static functional connectivity and dynamic functional connectivity alterations in the primary visual cortex among patients with high myopia via seed-based functional connectivity analysis","volume":"17","author":"Ji","year":"2023","journal-title":"Front Neurosci"},{"key":"2026073110201830000_bjo-2025-329114v1.27","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.13.04126","article-title":"Visual impairment and blindness caused by retinal diseases: A nationwide register-based study","volume":"13","author":"Zhou","year":"2023","journal-title":"J Glob Health"},{"key":"2026073110201830000_bjo-2025-329114v1.28","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1994.01090170074026"},{"key":"2026073110201830000_bjo-2025-329114v1.29","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.119.7.1050"},{"key":"2026073110201830000_bjo-2025-329114v1.30","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1056\/NEJMoa2012410","article-title":"Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19","volume":"382","author":"Geleris","year":"2020","journal-title":"N Engl J Med"},{"key":"2026073110201830000_bjo-2025-329114v1.31","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-022-01453-8"},{"key":"2026073110201830000_bjo-2025-329114v1.32","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.biopsych.2023.09.014","article-title":"Closed-Loop Brain Stimulation","volume":"95","author":"Zrenner","year":"2024","journal-title":"Biol Psychiatry"},{"key":"2026073110201830000_bjo-2025-329114v1.33","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-016-2603-0"},{"key":"2026073110201830000_bjo-2025-329114v1.34","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.47427","article-title":"Default mode-visual network hypoconnectivity in an autism subtype with pronounced social visual engagement difficulties","volume":"8","author":"Lombardo","year":"2019","journal-title":"Elife"},{"key":"2026073110201830000_bjo-2025-329114v1.35","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.brs.2024.12.1193","article-title":"Personalized whole-brain activity patterns predict human corticospinal tract activation in real-time","volume":"18","author":"Khatri","year":"2025","journal-title":"Brain Stimul"},{"key":"2026073110201830000_bjo-2025-329114v1.36","doi-asserted-by":"crossref","first-page":"114111","DOI":"10.1016\/j.isci.2025.114111","article-title":"Noninvasive transcranial brain stimulation for eye diseases and visual dysfunctions: A systematic review of RCTs","volume":"28","author":"Zhang","year":"2025","journal-title":"iScience"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2025-329114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:20:30Z","timestamp":1785518430000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2025-329114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":36,"alternative-id":["10.1136\/bjo-2025-329114"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2025-329114","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}