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Highlights from this issue
Frank Larkin
doi : 10.1136/bjophthalmol-2021-319985
British Journal of Ophthalmology 2021;105:i-ii
Publication objectives and processes at the British Journal of Ophthalmology: what authors and readers need to know
Frank Larkin, Ludwig M Heindl, Mingguang He, Mariya Moosajee
doi : 10.1136/bjophthalmol-2021-319381
British Journal of Ophthalmology 2021;105:1041-1042
Focal choroidal excavation: review of literature
Saurabh Verma, Vinod Kumar, Shorya Azad, Amber Amar Bhayana, Abhidnya Surve, Suneel Kumar, Pulak Agarwal, Rohan Chawla, Pradeep Venkatesh
doi : 10.1136/bjophthalmol-2020-316992
British Journal of Ophthalmology 2021;105:1043-1048
Focal choroidal excavation (FCE) is defined as an area of concavity in choroid detected on optical coherence tomography. These are mostly present in macular region without evidence of accompanying scleral ectasia or posterior staphyloma. Though initially considered to be congenital, increasing number of cases have been identified in association with other choroidal pathologies such as central serous choroidopathy, choroidal neovascularisation, polypoidal choroidal vasculopathy, choroiditis, choroidal tumours. In this review article, we aim to elaborate on the morphology, pathogenesis and differential diagnosis of FCE and specifically discuss the spectrum of diseases with known association along with the impact of their treatment on FCE
Corneal graft failure: an update
Jorge L Alio, Andrea Montesel, Fouad El Sayyad, Rafael Ignacio Barraquer, Francisco Arnalich-Montiel, Jorge Luis Alio Del Barrio
doi : 10.1136/bjophthalmol-2020-316705
British Journal of Ophthalmology 2021;105:1049-1058
Corneal graft surgery is one of the most successful forms of human solid-tissue transplantation, and nowadays, there is a worldwide expansion of the surgical volume of corneal grafts. This surgery is continuously evolving, with new surgical techniques and postoperative treatments that have considerably increased the chance of survival for the grafts. Despite the high rate of success, corneal transplantation is still complicated by a relevant risk of graft failure. This study investigates the causes that lead to the failure of the different corneal graft surgical techniques and provides an updated synthesis on this topic. A comprehensive review of the main pathological pathways that determine the failure of corneal grafts is provided, analysing the main risk factors and disclosing the survival rates of the principal form of corneal grafts. Our results revealed that penetrating keratoplasty has higher failure rates than lamellar keratoplasty, with immunological rejection being the leading cause of graft failure, followed by late endothelial failure (LEF) and ocular surface disorders. Postoperative glaucoma and dehiscence of the surgical wound represent other important causes of failure. Endothelial keratoplasty showed the lowest rates of failure in the mid-term, with LEF, detachment of the graft and primary graft failure representing the most common pathological reasons for failure.
Can we eradicate trachoma? A survey of stakeholders
Catherine E Oldenburg, Solomon Aragie, Abdou Amza, Anthony W Solomon, Jessica Brogdon, Benjamin F Arnold, Jeremy D Keenan, Thomas M Lietman
doi : 10.1136/bjophthalmol-2020-315815
British Journal of Ophthalmology 2021;105:1059-1062
Although tremendous progress towards the 2020 goal of global elimination of trachoma as a public health problem has been made, it will not be achieved. Future targets are now being considered. One option is changing the goal to eradication. We surveyed trachoma experts to assess beliefs related to trachoma eradication and determine perceived obstacles to achieving it.
Long-term anatomical and functional outcomes after autokeratoplasty
Pablo Sanjuán, Gemma Julio, Jennifer Bolaños, Juan Álvarez de Toledo, Gonzalo García de Oteyza, José Temprano, Rafael Ignacio Barraquer
doi : 10.1136/bjophthalmol-2020-316289
British Journal of Ophthalmology 2021;105:1063-1068
To evaluate the anatomical and functional outcomes of autologous contralateral penetrating keratoplasty (autokeratoplasty).
Keratoconus staging by decades: a baseline ABCD classification of 1000 patients in the Homburg Keratoconus Center
Elias Flockerzi, Kassandra Xanthopoulou, Susanne Christiane Goebels, Elena Zemova, Sonia Razafimino, Loïc Hamon, Theresia Jullien, Ulrike Klühspies, Timo Eppig, Achim Langenbucher, Berthold Seitz
doi : 10.1136/bjophthalmol-2020-316789
British Journal of Ophthalmology 2021;105:1069-1075
This retrospective cross-sectional study aims to analyse the keratoconus (KC) stage distribution at different ages within the Homburg Keratoconus Center (HKC).
Survival of the fittest: phacoemulsification outcomes in four corneal transplants by Dr Ramon Castroviejo
Jovany Jeomar Franco, Jose Luis Reyes Luis, Salma Rahim, Stephen Greenstein, Roberto Pineda
doi : 10.1136/bjophthalmol-2020-316435
British Journal of Ophthalmology 2021;105:1076-1081
To evaluate and report the outcomes following phacoemulsification on four eyes, 45 years or more after corneal transplantation.
The Cologne rebubbling study: a reappraisal of 624 rebubblings after Descemet membrane endothelial keratoplasty
Sebastian Siebelmann, Katharina Kolb, Paula Scholz, Mario Matthaei, Jeremy Franklin, Alexander Händel, Silvia Schrittenlocher, Takahiko Hayashi, Jose L Guell, Björn Bachmann, Claus Cursiefen
doi : 10.1136/bjophthalmol-2020-316478
British Journal of Ophthalmology 2021;105:1082-1086
To analyse graft detachments prior to rebubbling, the influence of rebubbling on the postoperative outcome after Descemet membrane endothelial keratoplasty (DMEK) and the need for rebubbling on the contralateral eye.
Visual outcomes after cataract surgery among the elderly residents in the ‘homes for the aged’ in South India: the Hyderabad Ocular Morbidity in Elderly Study
Srinivas Marmamula, Navya Rekha Barrenakala, Rajesh Challa, Thirupathi Reddy Kumbham, Satya Brahmanandam Modepalli, Ratnakar Yellapragada, Madhuri Bhakki, Jagadesh C Reddy, David S Friedman, Rohit C Khanna
doi : 10.1136/bjophthalmol-2020-317167
British Journal of Ophthalmology 2021;105:1087-1093
To report visual outcomes and factors associated with good visual outcomes after cataract surgery among the elderly residents in ‘homes for the aged’ in Hyderabad, India.
12-month randomised trial of 360° and 180° Schlemm’s canal incisions in suture trabeculotomy ab interno for open-angle glaucoma
Tomoki Sato, Takahiro Kawaji
doi : 10.1136/bjophthalmol-2020-316624
British Journal of Ophthalmology 2021;105:1094-1098
To perform a 12-month comparison between the different extents and locations of Schlemm’s canal incisions during suture trabeculotomy ab interno for open-angle glaucoma (OAG).
Automated detection of early-stage ROP using a deep convolutional neural network
Yo-Ping Huang, Haobijam Basanta, Eugene Yu-Chuan Kang, Kuan-Jen Chen, Yih-Shiou Hwang, Chi-Chun Lai, John P Campbell, Michael F Chiang, Robison Vernon Paul Chan, Shunji Kusaka, Yoko Fukushima, Wei-Chi Wu
doi : 10.1136/bjophthalmol-2020-316526
British Journal of Ophthalmology 2021;105:1099-1103
To automatically detect and classify the early stages of retinopathy of prematurity (ROP) using a deep convolutional neural network (CNN).
Bacterial infections as novel risk factors of severe diabetic retinopathy in individuals with type 1 diabetes
Johan Rasmus Simonsen, Asko Järvinen, Kustaa Hietala, Valma Harjutsalo, Carol Forsblom, Per-Henrik Groop, Markku Lehto
doi : 10.1136/bjophthalmol-2020-316202
British Journal of Ophthalmology 2021;105:1104-1110
Diabetic retinopathy (DR) is associated and shares many risk factors with other diabetic complications, including inflammation. Bacterial infections, potent inducers of inflammation have been associated with the development of diabetic complications apart from DR. Our aim was to investigate the association between bacterial infections and DR.
Longitudinal panretinal microaneurysm dynamics on ultra-widefield fluorescein angiography in eyes treated with intravitreal aflibercept for proliferative diabetic retinopathy in the recovery study
Amy Babiuch, Charles Clifton Wykoff, Jenna Hach, Sunil Srivastava, Katherine E Talcott, Hannah J Yu, Muneeswar Nittala, SriniVas Sadda, Michael S Ip, Thuy Le, Ming Hu, Jamie Reese, Justis P Ehlers
doi : 10.1136/bjophthalmol-2020-316952
British Journal of Ophthalmology 2021;105:1111-1115
Quantifying microaneurysms (MAs) turnover may be an objective measure for therapeutic response in diabetic retinopathy. This study assesses changes in MA counts on ultra-widefield fluorescein angiography (UWFA) in subjects undergoing treatment with intravitreal aflibercept injection (IAI) for proliferative diabetic retinopathy (PDR) in the Intravitreal Aflibercept for Retinal Non-Perfusion in Proliferative Diabetic Retinopathy(RECOVERY) study using an automated MA detection platform.
Rapid assessment of avoidable blindness-based healthcare costs of diabetic retinopathy in Hungary and its projection for the year 2045
Gábor Tóth, Hans Limburg, Dorottya Szabó, Gábor L Sándor, Zoltán Z Nagy, János Németh
doi : 10.1136/bjophthalmol-2020-316337
British Journal of Ophthalmology 2021;105:1116-1120
The purpose of this study was to estimate the total healthcare cost associated with diabetic retinopathy (DR) in the population aged 18 years and older in Hungary, and its projection for the year 2045.
Retinal ultra-wide-field colour imaging versus dilated fundus examination to screen for sickle cell retinopathy
Talal Alabduljalil, Crystal SY Cheung, Cynthia VandenHoven, Leslie D Mackeen, Melanie Kirby-Allen, Peter J Kertes, Wai-Ching Lam
doi : 10.1136/bjophthalmol-2020-316779
British Journal of Ophthalmology 2021;105:1121-1126
To compare ultra-wide-field colour fundus imaging (UWFI) to dilated fundus examination (DFE) for the screening of sickle cell retinopathy (SCR).
Association between cardiorespiratory fitness and handgrip strength with age-related macular degeneration: a population-based study
Andreas Katsimpris, Clemens Jürgens, Lisa Lüdtke, Bahls Martin, Till Ittermann, Sven Gläser, Marcus Dörr, Ralf Ewert, Konstantinos Volaklis, Stephan B. Felix, Frank Tost, Henry Völzke, Christa Meisinger, Sebastian E. Baumeister
doi : 10.1136/bjophthalmol-2020-316255
British Journal of Ophthalmology 2021;105:1127-1132
To assess whether cardiorespiratory fitness (CRF) and handgrip strength, two objective markers of physical fitness, are associated with age-related macular degeneration (AMD).
Detection of features associated with neovascular age-related macular degeneration in ethnically distinct data sets by an optical coherence tomography: trained deep learning algorithm
Tyler Hyungtaek Rim, Aaron Y Lee, Daniel S Ting, Kelvin Teo, Bjorn Kaijun Betzler, Zhen Ling Teo, Tea Keun Yoo, Geunyoung Lee, Youngnam Kim, Andrew C Lin, Seong Eun Kim, Yih Chung Tham, Sung Soo Kim, Ching-Yu Cheng, Tien Yin Wong, Chui Ming Gemmy Cheung
doi : 10.1136/bjophthalmol-2020-316984
British Journal of Ophthalmology 2021;105:1133-1139
The ability of deep learning (DL) algorithms to identify eyes with neovascular age-related macular degeneration (nAMD) from optical coherence tomography (OCT) scans has been previously established. We herewith evaluate the ability of a DL model, showing excellent performance on a Korean data set, to generalse onto an American data set despite ethnic differences. In addition, expert graders were surveyed to verify if the DL model was appropriately identifying lesions indicative of nAMD on the OCT scans.
Prevalence and predictors of myopic macular degeneration among Asian adults: pooled analysis from the Asian Eye Epidemiology Consortium
Yee Ling Wong, Xiangjia Zhu, Yih Chung Tham, Jason C S Yam, Keke Zhang, Charumathi Sabanayagam, Carla Lanca, Xiujuan Zhang, So Young Han, Wenwen He, Pradeep Susvar, Mihir Trivedi, Nan Yuan, Sarang Lambat, Rajiv Raman, Su Jeong Song, Ya Xing Wang, Mukharram M Bikbov, Vinay Nangia, Li Jia Chen, Tien Yin Wong, Ecosse Luc Lamoureux, Chi-Pui Pang, Ching Yu Cheng, Yi Lu, Jost B Jonas, Seang Mei Saw
doi : 10.1136/bjophthalmol-2020-316648
British Journal of Ophthalmology 2021;105:1140-1148
To determine the prevalence and predictors of myopic macular degeneration (MMD) in a consortium of Asian studies.
3-D assessment of gaze-induced eye shape deformations and downgaze-induced vitreous chamber volume increase in highly myopic eyes with staphyloma
Quan V Hoang, Stanley Chang, Daryle Jason Go Yu, Lawrence A Yannuzzi, K Bailey Freund, Jack Grinband
doi : 10.1136/bjophthalmol-2020-316084
British Journal of Ophthalmology 2021;105:1149-1154
To determine if the stress of normal eye movements results in gaze-induced globe deformations, vitreous chamber axial length and vitreous chamber axial volume (VCAV) change in highly myopic eyes.
Radiomics-based assessment of ultra-widefield leakage patterns and vessel network architecture in the PERMEATE study: insights into treatment durability
Prateek Prasanna, Vishal Bobba, Natalia Figueiredo, Duriye Damla Sevgi, Cheng Lu, Nathaniel Braman, Mehdi Alilou, Sumit Sharma, Sunil K Srivastava, Anant Madabhushi, Justis P Ehlers
doi : 10.1136/bjophthalmol-2020-317182
British Journal of Ophthalmology 2021;105:1155-1160
To evaluate the potential of radiomics-based ultra-widefield fluorescein angiography (UWFA)-derived imaging biomarkers in retinal vascular disease for predicting therapeutic durability of intravitreal aflibercept injection (IAI).
Small choroidal melanoma: outcomes following apical height dose brachytherapy
Renato Jose Yupari, James Bena, Allan Wilkinson, John Suh, Arun Singh
doi : 10.1136/bjophthalmol-2020-316873
British Journal of Ophthalmology 2021;105:1161-1165
To assess the outcomes of small choroidal melanoma following iodine-125 episcleral brachytherapy (apical height dose of 85 Gy).
Characterisation of thickness changes in the peripapillary retinal nerve fibre layer in patients with Leber’s hereditary optic neuropathy
Dan Wang, Hong-Li Liu, Yang-Yang Du, Jiajia Yuan, Xin Li, Zhen Tian, Haiqiang Zhou, Shuang Wang, Lin Song, Jian Sun, Xiao Xiao, Zhi-Tao Wang, Bin Li
doi : 10.1136/bjophthalmol-2020-316573
British Journal of Ophthalmology 2021;105:1166-1171
Limited studies have identified the changes in peripapillary retinal nerve fibre layer (pRNFL) thickness in patients with chronic Leber’s hereditary optic neuropathy (LHON) at different stages of the disease. We aimed to characterise the pRNFL thickness changes in patients with LHON having m.11778G>A (MT-ND4) mutation.
Antimicrobial peptides in human corneal tissue of patients with fungal keratitis
Imran Mohammed, Debasmita Mohanty, Dalia G. Said, Manas Ranjan Barik, Mamatha M Reddy, Ahmed Alsaadi, Sujata Das, Harminder Singh Dua, Ruchi Mittal
doi : 10.1136/bjophthalmol-2020-316329
British Journal of Ophthalmology 2021;105:1172-1177
Fungal keratitis (FK) is the leading cause of unilateral blindness in the developing world. Antimicrobial peptides (AMPs) have been shown to play an important role on human ocular surface (OS) during bacterial, viral and protozoan infections. In this study, our aim was to profile a spectrum of AMPs in corneal tissue from patients with FK during the active pase of infection and after healing.
Genetic associations of myopia severities and endophenotypes in children
Fen Fen Li, Shi Yao Lu, Shu Min Tang, Ka Wai Kam, Tam Pancy O S, Wilson W K Yip, Alvin L Young, Clement C Tham, Chi Pui Pang, Jason C. Yam, Li Jia Chen
doi : 10.1136/bjophthalmol-2020-316728
British Journal of Ophthalmology 2021;105:1178-1183
To investigate the associations of multiple single-nucleotide polymorphisms (SNPs) with the severities and endophenotypes of myopia in children.
Malcolm Kerr Muir, FRCS, FRCOphth, FRCP
Paul A R Meyer, Evelyn Brealey, Roger Buckley, John Marshall, Martin Snead
doi : 10.1136/bjophthalmol-2020-318706
British Journal of Ophthalmology 2021;105:1184-1186
