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Highlights from this issue
Frank Larkin
doi : 10.1136/bjophthalmol-2021-320553
British Journal of Ophthalmology 2021;105:i-ii.
Role of retinal pigment epithelium in age-related macular disease: a systematic review
Alan Bird
doi : 10.1136/bjophthalmol-2020-317447
British Journal of Ophthalmology 2021;105:1469-1474.
Age-related macular disease (AMD) is a major cause of blindness and there is little treatment currently available by which the progress of the basic disorder can be modulated. Histological and clinical studies show that the major tissues involved are the outer retina, retinal pigment epithelium, Bruch’s membrane and choroid. Because of a wide variation of phenotype from one case to another, it has been suggested that accurate phenotyping would be necessary for assessment of the effectiveness of treatment that is tissue-directed. However, based on findings from the study of human donor material and animal models of disease and of cell culture, it is concluded that retinal pigment epithelial dysfunction plays a central role in the disease process in most, if not all, cases of early AMD. The metabolism of phagosomal material, particularly lipids, and energy generation are interdependent, and dysfunction of both appears to be important in the genesis of disease. Evidence exists to suggest that both can be modulated therapeutically. These metabolic functions are amenable to further investigation in both the normal state and in disease. Once fully characterised, it is likely that treatment could be directed towards a limited number of functions in single tissue, thus simplifying treatment strategies.
Evolution of treatment paradigms in neovascular age-related macular degeneration: a review of real-world evidence
Vincent Daien, Robert P Finger, James S Talks, Paul Mitchell, Tien Y Wong, Taiji Sakamoto, Bora M Eldem, Jean-François Korobelnik
doi : 10.1136/bjophthalmol-2020-317434
British Journal of Ophthalmology 2021;105:1475-1479.
The aim of this work was to evaluate the contribution of real-world evidence (RWE) in changing anti-vascular endothelial growth factor (VEGF) therapy treatment practices and improving real-world treatment strategies for neovascular age-related macular degeneration (nAMD).
Long-term outcome of transcanalicular microdrill dacryoplasty: a minimally invasive alternative for dacryocystorhinostomy
Natasa Mihailovic, Alina Friederike Blumberg, Friederike Rosenberger, Viktoria Constanze Brücher, Larissa Lahme, Nicole Eter, Ralph-Laurent Merté, Maged Alnawaiseh
doi : 10.1136/bjophthalmol-2020-316146
British Journal of Ophthalmology 2021;105:1480-1484.
Dacryocystorhinostomy (DCR) remains the gold standard therapy for nasolacrimal duct obstruction (NLDO), but is invasive and does not maintain the physiology of the lacrimal pathway. With transcanlicular microdrill dacryoplasty (MDP), there is a minimally invasive alternative surgical approach. This study aimed to present this modern lacrimal duct surgery technique and to evaluate its long-term success rate in a large study population.
Minor salivary gland transplantation for severe dry eye disease due to cicatrising conjunctivitis: multicentre long-term outcomes of a modified technique
Jayesh Vazirani, Swapnil Bhalekar, Guillermo Amescua, Swati Singh, Sayan Basu
doi : 10.1136/bjophthalmol-2020-316611
British Journal of Ophthalmology 2021;105:1485-1490.
To report the clinical outcomes of autologous minor salivary gland transplantation (MSGT) for the treatment of severe dry eye disease caused by cicatrising conjunctivitis.
Clinical and confocal imaging findings in congenital corneal anaesthesia
Rebecca Guillon-Rolf, Scott Hau, Daniel F P Larkin
doi : 10.1136/bjophthalmol-2020-316672
British Journal of Ophthalmology 2021;105:1491-1496.
Congenital corneal anaesthesia (CCA) is an uncommon cause of corneal ulceration in young patients, with a reported poor visual prognosis. We correlated clinical findings in patients with CCA with corneal sub-basal nerve plexus (SBNP) morphology and dendritiform cell density (DCD) on confocal microscopy.
Keratitis occurring in patients treated with miltefosine for post-kala-azar dermal leishmaniasis
Rakhi Kusumesh, Anita Ambasta, Lalan Kumar Arya, Nilesh Mohan, Bibhuti Prassan Sinha, Vidyanand Ravidas
doi : 10.1136/bjophthalmol-2020-317325
British Journal of Ophthalmology 2021;105:1497-1503.
To describe the characteristic clinical features and management of keratitis in the patients receiving miltefosine for post-kala-azar dermal leishmaniasis (PKDL).
Effects of the re-esterified triglyceride (rTG) form of omega-3 supplements on dry eye following cataract surgery
Jongyeop Park, Young-Sik Yoo, Eunhae Shin, Gyule Han, Kyungyoon Shin, Dong Hui Lim, Tae-Young Chung
doi : 10.1136/bjophthalmol-2020-317164
British Journal of Ophthalmology 2021;105:1504-1509.
To evaluate the clinical outcomes of the systemic re-esterified triglyceride (rTG) form of omega-3 fatty acids in patients with dry eye symptoms after cataract surgery.
Impact of intraocular lens characteristics on intraocular lens dislocation after cataract surgery
Christoph Fidel Mayer-Xanthaki, Gudrun Pregartner, Nino Hirnschall, Thomas Falb, Michael Sommer, Oliver Findl, Andreas Wedrich
doi : 10.1136/bjophthalmol-2020-317124
British Journal of Ophthalmology 2021;105:1510-1514.
To assess the influence of intraocular lens (IOL) characteristics on IOL dislocations after cataract surgery.
Recommendations for the management of ocular sarcoidosis from the International Workshop on Ocular Sarcoidosis
Hiroshi Takase, Nisha R Acharya, Kalpana Babu, Bahram Bodaghi, Moncef Khairallah, Peter J McCluskey, Nattaporn Tesavibul, Jennifer E Thorne, Ilknur Tugal-Tutkun, Joyce H Yamamoto, Narsing A Rao, Justine R Smith, Manabu Mochizuki
doi : 10.1136/bjophthalmol-2020-317354
British Journal of Ophthalmology 2021;105:1515-1519.
To establish expert recommendations for the management of ocular sarcoidosis (OS).
Foveal cone count reduction in resolved endophthalmitis: an adaptive optics scanning laser ophthalmoscopy (AO-SLO)-based prospective pilot study
Vivek Pravin Dave, Sanjay Kumar, Yasmeen Mulani, Ashutosh Richhariya, Rajeev Reddy Pappuru, Taraprasad Das
doi : 10.1136/bjophthalmol-2020-317309
British Journal of Ophthalmology 2021;105:1520-1524.
To report the foveal cone count in eyes with resolved endophthalmitis vis-à-vis normal fellow eyes using an indigenous adaptive optics scanning laser ophthalmoscopy (AO-SLO).
Long-term efficacy of early infliximab-induced remission for refractory uveoretinitis associated with Behçet’s disease
Hiroshi Keino, Takayo Watanabe, Makiko Nakayama, Yoshinori Komagata, Kazuhito Fukuoka, Annabelle A Okada
doi : 10.1136/bjophthalmol-2020-316892
British Journal of Ophthalmology 2021;105:1525-1533.
To evaluate long-term efficacy of infliximab (IFX) in refractory uveoretinitis associated with Behçet’s disease (BD) depending on uveoretinitis duration.
Intrasession repeatability and intersession reproducibility of peripapillary OCTA vessel parameters in non-glaucomatous and glaucomatous eyes
Jae Chang Lee, Dominic J Grisafe, Bruce Burkemper, Brenda R Chang, Xiao Zhou, Zhongdi Chu, Ali Fard, Mary Durbin, Brandon J Wong, Brian J Song, Benjamin Y Xu, Ruikang Wang, Grace M Richter
doi : 10.1136/bjophthalmol-2020-317181
British Journal of Ophthalmology 2021;105:1534-1541.
To compare intrasession repeatability versus intersession reproducibility of the peripapillary vessel parameters using optical microangiography–based optical coherence tomography angiography (OCTA) in non-glaucomatous and glaucomatous eyes.
Referenced scans improve the repeatability of optical coherence tomography angiography measurements in normal and glaucoma eyes
Harsha Laxmana Rao, Srilakshmi Dasari, Mohammed Riyazuddin, Raghavan Lavanya, Narenda K P, Zia Sultan Pradhan, Sasan Moghimi, Kaweh Mansouri, Carroll A B Webers, Robert N Weinreb
doi : 10.1136/bjophthalmol-2020-316480
British Journal of Ophthalmology 2021;105:1542-1547.
To compare the repeatability of peripapillary perfusion density and flux index measurements on referenced and non-referenced optical microangiography (OMAG) scans in normal, glaucoma suspect and glaucoma eyes.
Deep learning for automated glaucomatous optic neuropathy detection from ultra-widefield fundus images
Zhongwen Li, Chong Guo, Duoru Lin, Danyao Nie, Yi Zhu, Chuan Chen, Lanqin Zhao, Jinghui Wang, Xulin Zhang, Meimei Dongye, Dongni Wang, Fabao Xu, Chenjin Jin, Ping Zhang, Yu Han, Pisong Yan, Ying Han, Haotian Lin
doi : 10.1136/bjophthalmol-2020-317327
British Journal of Ophthalmology 2021;105:1548-1554.
To develop a deep learning system for automated glaucomatous optic neuropathy (GON) detection using ultra-widefield fundus (UWF) images.
Dual-input convolutional neural network for glaucoma diagnosis using spectral-domain optical coherence tomography
Sukkyu Sun, Ahnul Ha, Young Kook Kim, Byeong Wook Yoo, Hee Chan Kim, Ki Ho Park
doi : 10.1136/bjophthalmol-2020-316274
British Journal of Ophthalmology 2021;105:1555-1560.
To evaluate, with spectral-domain optical coherence tomography (SD-OCT), the glaucoma-diagnostic ability of a deep-learning classifier.
Outcome of trabeculectomy versus Ahmed glaucoma valve implantation in the surgical management of glaucoma in patients with Sturge–Weber syndrome
Bipul Kumer De Sarker, Mohammad Ibn Abdul Malek, Sheikh M A Mannaf, Quazi Sazzad Iftekhar, Mallika Mahatma, Mridul Kumar Sarkar, Mostafizur Rahman
doi : 10.1136/bjophthalmol-2020-317098
British Journal of Ophthalmology 2021;105:1561-1565.
To compare the surgical outcomes of trabeculectomy versus Ahmed glaucoma valve (AGV) implantation in the surgical management of glaucoma in patients with Sturge–Weber syndrome (SWS).
Lifetime visual outcomes of patients undergoing trabeculectomy
Ruth Chen, Anthony J King
doi : 10.1136/bjophthalmol-2020-317004
British Journal of Ophthalmology 2021;105:1566-1570.
The most important outcome for patients undergoing trabeculectomy is to maintain the quality of life in their remaining years. This study quantifies end of life vision in terms of visual acuity (VA) and visual field status.
Multicentre study of 4626 patients assesses the effectiveness, safety and burden of two categories of treatments for central retinal vein occlusion: intravitreal anti-vascular endothelial growth factor injections and intravitreal Ozurdex injections
Richard Gale, Claire Gill, Maria Pikoula, Aaron Y Lee, Rachel L W Hanson, Spiros Denaxas, Catherine Egan, Adnan Tufail, Paul Taylor, UK EMR Database Users Group
doi : 10.1136/bjophthalmol-2020-317306
British Journal of Ophthalmology 2021;105:1571-1576.
To assess the effectiveness, burden and safety of two categories of treatment for central retinal vein occlusion (CRVO): intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) and dexamethasone (Ozurdex).
Quantification of vascular and neuronal changes in the peripapillary retinal area secondary to diabetic retinopathy
Luisa Frizziero, Raffaele Parrozzani, Davide Londei, Elisabetta Pilotto, Edoardo Midena
doi : 10.1136/bjophthalmol-2020-316468
British Journal of Ophthalmology 2021;105:1577-1583.
To investigate and quantify peripapillary vascular and neuronal changes secondary to diabetic retinopathy, using spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA).
Scotopic microperimetric sensitivity and inner choroid flow deficits as predictors of progression to nascent geographic atrophy
Giulia Corradetti, Liran Tiosano, Marco Nassisi, Ahmed Roshdy Alagorie, Federico Corvi, Muneeswar Gupta Nittala, SriniVas Sadda
doi : 10.1136/bjophthalmol-2020-316893
British Journal of Ophthalmology 2021;105:1584-1590.
To assess the role of microperimetric retinal sensitivity (MPRS) and inner choroid flow deficits (IC FD) in predicting the development of incomplete retinal pigment epithelial and outer retinal atrophy (iRORA) in intermediate AMD (i-AMD).
Ophthalmic manifestations of myelin oligodendrocyte glycoprotein-IgG-associated disorder other than optic neuritis: a systematic review
Amir R Vosoughi, Jennifer Ling, Kenneth T Tam, Jayden Blackwood, Jonathan A Micieli
doi : 10.1136/bjophthalmol-2020-317267
British Journal of Ophthalmology 2021;105:1591-1598.
Optic neuritis (ON) is the primary ophthalmic manifestation of myelin oligodendrocyte glycoprotein-IgG-associated disorder (MOGAD), but numerous reports have expanded the visual manifestations of this condition. The goal of this study was to synthesise the extensive literature on this topic to help ophthalmologists understand when testing for MOG-IgG should be considered.
Adjuvant use of laser in eyes with macular retinoblastoma treated with primary intravenous chemotherapy
Andrew W Stacey, Mai Tsukikawa, Ido Didi Fabian, Sarah Turner, Helen Jenkinson, Vicky Smith, Zishan Naeem, Bruce Morland, John R Ainsworth, M Ashwin Reddy, Manoj Parulekar, Mandeep S Sagoo
doi : 10.1136/bjophthalmol-2020-316862
British Journal of Ophthalmology 2021;105:1599-1603.
Adjuvant use of laser with systemic chemotherapy for treatment of retinoblastoma may reduce recurrence rates while also causing local side effects. Information is lacking on the effect of laser on visual outcomes.
Visual hallucinations and sight loss in children and young adults: a retrospective case series of Charles Bonnet syndrome
Lee Jones, Mariya Moosajee
doi : 10.1136/bjophthalmol-2020-317237
British Journal of Ophthalmology 2021;105:1604-1609.
Charles Bonnet syndrome (CBS) is a complication of sight loss affecting all ages; yet, few childhood cases have been reported. Our aim is to raise awareness of this under-reported association occurring in children and young adults in order to prevent psychological harm in this age group.
The role of EP2 receptors in mediating the ultra-long-lasting intraocular pressure reduction by JV-GL1
Jacques A Bertrand, David F Woodward, Joseph M Sherwood, Jenny W Wang, Darryl R Overby
doi : 10.1136/bjophthalmol-2020-317762
British Journal of Ophthalmology 2021;105:1610-1616.
A single application of JV-GL1 substantially lowers non-human primate intraocular pressure (IOP) for about a week, independent of dose. This highly protracted effect does not correlate with its ocular biodisposition or correlate with the once-daily dosing regimen for other prostanoid EP2 receptor agonists such as trapenepag or omidenepag. The underlying pharmacological mechanism for the multiday extended activity of JV-GL1 is highly intriguing. The present studies were intended to determine EP2 receptor involvement in mediating the long-term ocular hypotensive activity of JV-GL1 by using mice genetically deficient in EP2 receptors.
