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Highlights from this issue
Frank Larkin
doi : 10.1136/bjophthalmol-2021-320402
British Journal of Ophthalmology 2021;105:i-ii.
The era of artificial intelligence and virtual reality: transforming surgical education in ophthalmology
Shaunak K Bakshi, Shawn R Lin, Daniel Shu Wei Ting, Michael F Chiang, James Chodosh
doi : 10.1136/bjophthalmol-2020-316845
British Journal of Ophthalmology 2021;105:1325-1328.
Training the modern ophthalmic surgeon is a challenging process. Microsurgical education can benefit from innovative methods to practice surgery in low-risk simulations, assess and refine skills in the operating room through video content analytics, and learn at a distance from experienced surgeons. Developments in emerging technologies may allow us to pursue novel forms of instruction and build on current educational models. Artificial intelligence, which has already seen numerous applications in ophthalmology, may be used to facilitate surgical tracking and evaluation. Within immersive technology, growth in the space of virtual reality head-mounted displays has created intriguing possibilities for operating room simulation and observation. Here, we explore the applications of these technologies and comment on their future in ophthalmic surgical education.
100 most-cited articles on diabetic retinopathy
Barry Moses Quan Ren Koh, Riswana Banu, Simon Nusinovici, Charumathi Sabanayagam
doi : 10.1136/bjophthalmol-2020-316609
British Journal of Ophthalmology 2021;105:1329-1336.
Diabetic retinopathy (DR) research has had significant advancements over the past decades. We analysed the impact and characteristics of the top 100 (T100) most-cited articles in DR research. The Scopus database was searched for articles published from 1960 to June 2020 by two independent investigators. The T100 DR articles were published between 1961 and 2017 with median citations of 503 (range: 306–20 100); 84% were published after 1990. More than half (59%) were published in general medical/diabetes journals while 37% in ophthalmology journals. The top six journals contributed to 56% of the T100: Ophthalmology (n=13), Archives of Ophthalmology (n=12), Diabetes (n=9), New England Journal of Medicine (n=8), Journal of the American Medical Association (n=7) and The Lancet (n=7). Although observational studies were most popular (33%), randomised controlled trials (RCTs, 24%) published in journals with higher impact factor (IF) and citations (median IF and citations=7.113, 503 vs 21.437, 696.5, both p-value<0.05). 33 of the T100 were cited by several international DR clinical guidelines. The USA contributed to 63% of T100, but 18% of articles published after 2000 came from Asia. More than 80% of both first and last authors were men. Artificial intelligence (AI) to screen for DR ranked 14th and 99th despite recent publications in 2016 and 2017, respectively. To conclude, our T100 analysis showed that RCTs were most-cited and more articles were published in non-ophthalmology than ophthalmology journals. It highlights the impact the T100 DR has in shaping guidelines used to date in DR management, identifies AI for DR screening as an emerging area and shows a contemporary rise of Asian contribution in DR research.
Orbital implants: material matters
Ludwig M Heindl, Alexander Christopher Rokohl
doi : 10.1136/bjophthalmol-2021-319849
British Journal of Ophthalmology 2021;105:1337.
Case series of shrinking hydroxyapatite orbital implants
Louis S Han, Rodney B Keillor, Robert G Weatherhead
doi : 10.1136/bjophthalmol-2021-319397
British Journal of Ophthalmology 2021;105:1338-1340.
An orbital implant is used after enucleation or evisceration surgery to replace the volume lost and to aid in prosthesis fitting and movement. Different materials have been used through the years. The authors noted that with bone-derived hydroxyapatite orbital implants, some patients lose their orbital volume.
Nationwide trends in the incidence of orbital lymphoma from 1999 to 2016 in South Korea
Su Kyung Jung, Jiwon Lim, Suk Woo Yang, Young-Joo Won
doi : 10.1136/bjophthalmol-2020-316796
British Journal of Ophthalmology 2021;105:1341-1345.
Lymphomas are the most frequent neoplasm of the orbit. However, the epidemiology of orbital lymphomas is not well reported. This study aimed to provide a population-based report on the epidemiology of orbital lymphomas and measure the trends in the incidence of orbital lymphoma cancer in South Korea.
UK National Artificial Eye Questionnaire study: comparisons between cosmetic shell and artificial eye users. Part 1: demographics, comfort and satisfaction
Yinon Shapira, Emma Worrell, Katja Ullrich, Andre Litwin, Raman Malhotra
doi : 10.1136/bjophthalmol-2020-317015
British Journal of Ophthalmology 2021;105:1346-1351.
To compare the unique experiences related to artificial eye (AE) versus cosmetic shell (CS) wear.
Palpebral lobe of the human lacrimal gland: morphometric analysis in normal versus dry eyes
Swati Singh, Swapna S Shanbhag, Sayan Basu
doi : 10.1136/bjophthalmol-2020-316929
British Journal of Ophthalmology 2021;105:1352-1357.
To study the morphological features of the palpebral lobe of the main lacrimal gland in normal and dry eyes.
Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study
Puneet Jain, Paul T Finger, Maria Fili, Bertil Damato, Sarah E Coupland, Heinrich Heimann, Nihal Kenawy, Niels J Brouwer, Marina Marinkovic, Sjoerd G Van Duinen, Jean Pierre Caujolle, Celia Maschi, Stefan Seregard, David Pelayes, Martin Folgar, Yacoub A Yousef, Hatem Krema, Brenda Gallie, Alberto Calle-Vasquez
doi : 10.1136/bjophthalmol-2020-316293
British Journal of Ophthalmology 2021;105:1358-1364.
To relate conjunctival melanoma characteristics to local control.
Influence of corneal guttae and nuclear cataract on contrast sensitivity
Victor A Augustin, Julia M Weller, Friedrich E Kruse, Theofilos Tourtas
doi : 10.1136/bjophthalmol-2019-315206
British Journal of Ophthalmology 2021;105:1365-1370.
To evaluate the contrast sensitivity in patients with nuclear cataract and corneal guttae compared to patients with nuclear cataract without guttae.
Factors affecting central corneal thickness measurement agreement between Scheimpflug imaging and ultrasound pachymetry in keratoconus
Nir Sorkin, Anamika Ohri, Hyejung Jung, Lacey Haines, Luigina Sorbara, Michael Mimouni, Neera Singal, Wendy Hatch, KEI CXL Working Group
doi : 10.1136/bjophthalmol-2020-317111
British Journal of Ophthalmology 2021;105:1371-1375.
To evaluate the agreement of central corneal thickness (CCT) measurement between Scheimpflug imaging and ultrasound (U/S) pachymetry in keratoconic eyes, and investigate factors that affect the agreement.
Clinical outcomes of KeraVio using violet light: emitting glasses and riboflavin drops for corneal ectasia: a pilot study
Hidenaga Kobashi, Hidemasa Torii, Ikuko Toda, Shinichiro Kondo, Motozumi Itoi, Kazuo Tsubota
doi : 10.1136/bjophthalmol-2020-316974
British Journal of Ophthalmology 2021;105:1376-1382.
We developed a novel technology consisting of violet light (VL)-emitting glasses and defined the combination of VL irradiation and riboflavin treatment as KeraVio. Our goal was to evaluate the clinical results of KeraVio in patients with progressive corneal ectasia.
Glaucoma conversion of the contralateral eye in unilateral normal-tension glaucoma patients: a 5-year follow-up study
Jin-Soo Kim, Hyuk Jin Choi, Ki Ho Park
doi : 10.1136/bjophthalmol-2020-316371
British Journal of Ophthalmology 2021;105:1383-1389.
To investigate clinical characteristics and risk factors for glaucoma conversion of the contralateral eye in unilateral normal-tension glaucoma (NTG) patients.
Intraocular pressure–lowering medications during pregnancy and risk of neonatal adverse outcomes: a propensity score analysis using a large database
Yohei Hashimoto, Nobuaki Michihata, Hayato Yamana, Daisuke Shigemi, Kojiro Morita, Hiroki Matsui, Hideo Yasunaga, Makoto Aihara
doi : 10.1136/bjophthalmol-2020-316198
British Journal of Ophthalmology 2021;105:1390-1394.
To investigate the association between exposure to intraocular pressure (IOP)–lowering medications during pregnancy and neonatal adverse outcomes.
Rates of spondyloarthropathies vary with age and ethnicity in HLAB27 uveitis
Ruhella R Hossain, Haya H Al-Ani, Joanne L Sims, Karen Lindsay, Rachael L Niederer
doi : 10.1136/bjophthalmol-2020-316150
British Journal of Ophthalmology 2021;105:1395-1398.
To determine associations between HLAB27-positive uveitis, ethnicity and seronegative spondyloarthropathies (SpAs) in a New Zealand population.
Diagnostic value of lymphopaenia and elevated serum ACE in patients with uveitis
Philippine Cotte, Pierre Pradat, Laurent Kodjikian, Yvan Jamilloux, Pascal Seve
doi : 10.1136/bjophthalmol-2020-316563
British Journal of Ophthalmology 2021;105:1399-1404.
To evaluate the diagnostic worth of elevated serum ACE (sACE) and lymphopaenia, singly or combined, in diagnosing sarcoid uveitis.
Long-term natural history of highly myopic eyes with a dome-shaped macula with or without untreated serous retinal detachment: a 4-year follow-up study
Francesco Viola, Gaia Leone, Elena Garoli, Claudia Mainetti, Davide Galli, Alessandro Invernizzi
doi : 10.1136/bjophthalmol-2020-316629
British Journal of Ophthalmology 2021;105:1405-1409.
To evaluate the long-term functional and morphological changes occurring in myopic eyes with a dome-shaped macula (DSM), with or without untreated serous retinal detachment (SRD).
Peripheral exudative haemorrhagic chorioretinopathy: a widefield imaging study
Federico Zicarelli, Chiara Preziosa, Giovanni Staurenghi, Marco Pellegrini
doi : 10.1136/bjophthalmol-2020-317083
British Journal of Ophthalmology 2021;105:1410-1414.
To study widefield imaging features, analyse risk factors for progression and compare treatment modalities of peripheral exudative haemorrhagic chorioretinopathy (PEHCR).
Non-neovascular age-related macular degeneration with subretinal fluid
Assaf Hilely, Adrian Au, K Bailey Freund, Anat Loewenstein, Eric H Souied, Dinah Zur, Riccardo Sacconi, Enrico Borrelli, Enrico Peiretti, Claudio Iovino, Yoshimi Sugiura, Abdallah A Ellabban, Jordi Monés, Nadia K. Waheed, Sengul Ozdek, Duygu Yalinbas, Sarah Thiele, Luísa Salles de Moura Mendonça, Mee Yon Lee, Won Ki Lee, Pierre Turcotte, Vittorio Capuano, Meryem Filali Ansary, Usha Chakravarthy, Albrecht Lommatzsch, Frederic Gunnemann, Daniel Pauleikhoff, Michael S Ip, Giuseppe Querques, Frank G Holz, Richard F Spaide, SriniVas Sadda, David Sarraf
doi : 10.1136/bjophthalmol-2020-317326
British Journal of Ophthalmology 2021;105:1415-1420.
To evaluate the various patterns of subretinal fluid (SRF) in eyes with age-related macular degeneration (AMD) in the absence of macular neovascularisation (MNV) and to assess the long-term outcomes in these eyes.
Fractal analysis of polypoidal choroidal neovascularisation in age-related macular degeneration
Rita Serra, Florence Coscas, Antonio Pinna, Diogo Cabral, Gabriel Coscas, Eric H Souied
doi : 10.1136/bjophthalmol-2020-317011
British Journal of Ophthalmology 2021;105:1421-1426.
To describe optical coherence tomography angiography (OCTA) features of polypoidal choroidal neovascularisation (PCNV) secondary to age-related macular degeneration.
Geographic distributions of age-related macular degeneration incidence: a systematic review and meta-analysis
Miao Zhou, Pei-Chen Duan, Jing-Hong Liang, Xiao-Feng Zhang, Chen-Wei Pan
doi : 10.1136/bjophthalmol-2020-316820
British Journal of Ophthalmology 2021;105:1427-1434.
We performed a systematic review and meta-analysis to summarise the geographic distribution of age-related macular degeneration (AMD) incidence.
Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries
Ido Didi Fabian, Andrew W Stacey, Allen Foster, Tero T Kivelä, Francis L. Munier, Naama Keren-Froim, Nir Gomel, Nathalie Cassoux, Mandeep S Sagoo, M Ashwin Reddy, Lamis Al Harby, Marcia Zondervan, Covadonga Bascaran, Elhassan Abdallah, Shehu U Abdullahi, Sahadatou Adamou Boubacar, Dupe S Ademola-Popoola, Adedayo Adio, Ada E Aghaji, Silvia Alarcón Portabella, Amadou I Alfa Bio, Amany M Ali, Donjeta B Alia, Charlotta All-Eriksson, Argentino A Almeida, Khalifa M Alsawidi, Romanzo Antonino, Nicholas J Astbury, Rose Atsiaya, Julia Balaguer, Walentyna Balwierz, Honorio Barranco, Maja Beck Popovic, Sarra Benmiloud, Nissrine Bennani Guebessi, Rokia C Berete, Shelley J Biddulph, Eva M Biewald, Sharon Blum, Nadia Bobrova, Marianna Boehme, Norbert Bornfeld, Gabrielle C Bouda, Hédi Bouguila, Amaria Boumedane, Bénédicte G Brichard, Michael Capra l, Guilherme Castela, Jaume Català-Mora, Guillermo L Chantada, Violeta S Chernodrinska, Faraja S Chiwanga, Krzysztof Cieslik, Codruta Comsa, Maria G Correa Llano, Monika Csóka, Isac V Da Gama, Alan Davidson, Patrick De Potter, Laurence Desjardins, Monica D Dragomir, Magritha Du Bruyn, Asmaa El Kettani, Amal M Elbahi, Dina Elgalaly, Alaa M Elhaddad, Moawia M Ali Elhassan, Mahmoud M Elzembely, Vera A Essuman, Ted Grimbert A Evina, Oluyemi Fasina, Ana Fernández-Teijeiro, Moira Gandiwa, David García Aldana, Jennifer A Geel, Zelalem Gizachew, Pernille A Gregersen, Koffi M Guedenon, Theodora Hadjistilianou, Sadiq Hassan, Stanislava Hederova, Laila Hessissen, Diriba F Hordofa, Marlies Hummlen, Kristina Husakova, Russo Ida, Vesna R Ilic, Helen Jenkinson, Theophile B Amani Kabesha, Rolande L Kabore, Abubakar Kalinaki, Noa Kapelushnik, Tamar Kardava, Pavlin Kroumov Kemilev, Tomas Kepak, Zaza Khotenashvili, Artur Klett, Jess Elio Kosh Komba Palet, Dalia Krivaitiene, Mariana Kruger, Alice Kyara, Eva S Lachmann, Slobodanka Latinovi?, Karin Lecuona, Robert M Lukamba, Livia Lumbroso, Lesia Lysytsia, Erika Maka, Mayuri Makan, Chatonda Manda, Nieves Martín Begue, Ibrahim O Matende, Marchelo Matua, Ismail Mayet, Freddy B Mbumba, Aemero A Mengesha, Edoardo Midena, Furahini G Mndeme, Ahmed A Mohamedani, Annette C Moll, Claude Moreira, Mchikirwa S Msina, Gerald Msukwa, Kangwa I Muma, Gabriela Murgoi, Kareem O Musa, Hamzah Mustak, Okwen M Muyen, Gita Naidu, Larisa Naumenko, Paule Aïda Ndoye Roth, Vladimir Neroev, Marina Nikitovic, Elizabeth D Nkanga, Henry Nkumbe, Mutale Nyaywa, Ghislaine Obono-Obiang, Ngozi C Oguego, Andrzej Olechowski, Alexander Hugo Oscar, Peter Osei-Bonsu, Sally L Painter, Vivian Paintsil, Luisa Paiva, Ruzanna Papyan, Raffaele Parrozzani, Manoj Parulekar, Katarzyna Pawinska-Wasikowska, Sanja Peri?, Remezo Philbert, Pavel Pochop, Vladimir G Polyakov, Manca T Pompe, Jonathan J Pons, Léa Raobela, Lorna A Renner, David Reynders, Dahiru Ribadu, Mussagy M Riheia, Petra Ritter-Sovinz, Svetlana Saakyan, Azza MA Said, Sonsoles San Román Pacheco, Trish A Scanlan, Judy Schoeman, Stefan Seregard, Sadik T Sherief, Sidi Sidi Cheikh, Sónia Silva, Tetyana Sorochynska, Grace Ssali, Christina Stathopoulos, Branka Stirn Kranjc, David K Stones, Karel Svojgr, Fatoumata Sylla, Gevorg Tamamyan, Alketa Tandili, Bekim Tateshi, Tuyisabe Theophile, Fousseyni Traoré, Harba Tyau-Tyau, Ali B Umar, Steen F Urbak, Tatiana L Ushakova, Sandra Valeina, Milo van Hoefen Wijsard, Nevyana V Veleva-Krasteva, Maris Viksnins, Werner Wackernagel, Keith Waddell, Patricia D Wade, Amina H Wali Nigeria, Amelia DC Wime, Charlotte Wolley Dod, Jenny M Yanga, Vera A Yarovaya, Andrey A Yarovoy, Ekhtelbenina Zein, Shirley Sharabi, Katsiaryna Zhilyaeva, Othman AO Ziko, Richard Bowman
doi : 10.1136/bjophthalmol-2020-316613
British Journal of Ophthalmology 2021;105:1435-1443.
The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe.
Vascular findings in primarily affected and fellow eyes of middle-aged patients with Coats’ disease using multimodal imaging
Claudia Brockmann, Julia Löwen, Shideh Schönfeld, Mirjam Rossel-Zemkouo, Ira Seibel, Sibylle Winterhalter, Bert Müller, Antonia M Joussen
doi : 10.1136/bjophthalmol-2020-317101
British Journal of Ophthalmology 2021;105:1444-1453.
To investigate the retinal vascular structure and capillary anomalies of affected and fellow eyes of patients with unilateral Coats’ disease using multimodal imaging.
Prognostic value of TERT promoter mutations in conjunctival melanomas in addition to clinicopathological features
J A van Ipenburg, N C Naus, H J Dubbink, R van Ginderdeuren, G S Missotten, D Paridaens, R M Verdijk
doi : 10.1136/bjophthalmol-2020-317405
British Journal of Ophthalmology 2021;105:1454-1461.
To evaluate the prognostic value of clinical, histopathological and molecular features and to relate different treatment modalities to clinical outcome in conjunctival melanomas (CM).
Human leucocyte antigen alleles confer susceptibility and progression to Graves’ ophthalmopathy in a Southern Chinese population
Xiaosheng Huang, Guiqin Liu, Shaoyi Mei, Jiamin Cai, Jing Rao, Minzhong Tang, Tianhui Zhu, Wenchiew Chen, Shiming Peng, Yan Wang, Ye Ye, Tong Zhang, Zhihui Deng, Jun Zhao
doi : 10.1136/bjophthalmol-2020-317091
British Journal of Ophthalmology 2021;105:1462-1468.
To evaluate the contributions of human leucocyte antigen (HLA) class I and II genes in the development of Graves’ ophthalmopathy (GO) in a Southern Chinese population.
