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Highlights from this issue
Frank Larkin
doi : 10.1136/bjophthalmol-2021-320721
British Journal of Ophthalmology 2021;105:i-ii
A review of the clinical applications of drug delivery systems for the treatment of ocular anterior segment inflammation
Chee Wai Wong, Josbert M Metselaar, Gert Storm, Tina T Wong
doi : 10.1136/bjophthalmol-2020-315911
British Journal of Ophthalmology 2021;105:1617-1622
Ocular anterior segment inflammation is a medical problem that is seen in cases of cataract surgery and non-infectious anterior uveitis. Inadequately treated anterior segment inflammation can lead to sight-threatening conditions such as corneal oedema, glaucoma and cystoid macular oedema. The mainstay of treatment for anterior segment inflammation is topical steroid eye-drops. However, several drawbacks limit the critical value of this treatment, including low bioavailability, poor patient compliance, relatively difficult administration manner and risk of blurring of vision and ocular irritation. A drug delivery system (DDS) that can provide increased bioavailability and sustained delivery while being specifically targeted towards inflamed ocular tissue can potentially replace daily eye-drops as the gold standard for management of anterior segment inflammation. The various DDS for anti-inflammatory drugs for the treatment of anterior segment inflammation are listed and summarised in this review, with a focus on commercially available products and those in clinical trials. Dextenza, INVELTYS, Dexycu and Bromsite are examples of DDS that have enjoyed success in clinical trials leading to FDA approval. Nanoparticles and ocular iontophoresis form the next wave of DDS that have the potential to replace topical steroids eye-drops as the treatment of choice for anterior segment inflammation. With the current relentless pace of ophthalmic drug delivery research, the pursuit of a new standard of treatment that eliminates the problems of low bioavailability and patient compliance may soon be realised.
Structural evaluation in inherited retinal diseases
Malena Daich Varela, Burak Esener, Shaima A Hashem, Thales Antonio Cabral de Guimaraes, Michalis Georgiou, Michel Michaelides
doi : 10.1136/bjophthalmol-2021-319228
British Journal of Ophthalmology 2021;105:1623-1631
Ophthalmic genetics is a field that has been rapidly evolving over the last decade, mainly due to the flourishing of translational medicine for inherited retinal diseases (IRD). In this review, we will address the different methods by which retinal structure can be objectively and accurately assessed in IRD. We review standard-of-care imaging for these patients: colour fundus photography, fundus autofluorescence imaging and optical coherence tomography (OCT), as well as higher-resolution and/or newer technologies including OCT angiography, adaptive optics imaging, fundus imaging using a range of wavelengths, magnetic resonance imaging, laser speckle flowgraphy and retinal oximetry, illustrating their utility using paradigm genotypes with on-going therapeutic efforts/trials.
Association between atopic keratoconjunctivitis and the risk of corneal ulcer
Ren-Long Jan, Shih-Feng Weng, Jhi-Joung Wang, Sung-Huei Tseng, Yuh-Shin Chang
doi : 10.1136/bjophthalmol-2020-316206
British Journal of Ophthalmology 2021;105:1632-1637
To investigate the risk of corneal ulcer in patients with atopic keratoconjunctivitis (AKC).
Pellucid marginal degeneration versus keratoconus: distinction with wide-field SD-OCT corneal sublayer pachymetry
Niklas Mohr, Mehdi Shajari, Daniel Krause, Stefan Kassumeh, Jakob Siedlecki, Siegfried G Priglinger, Wolfgang J Mayer, Nikolaus Luft
doi : 10.1136/bjophthalmol-2020-316496
British Journal of Ophthalmology 2021;105:1638-1644
To evaluate the capability of wide-field spectral-domain optical coherence tomography (SD-OCT) corneal sublayer pachymetry to distinguish between keratoconus and pellucid marginal degeneration (PMD).
Compression sutures combined with intracameral air injection versus thermokeratoplasty for acute corneal hydrops: a prospective-randomised trial
Zelin Zhao, Siteng Wu, Weina Ren, Qinxiang Zheng, Cong Ye, Andy D. Kim, Vishal Jhanji, Michael T. M. Wang, Wei Chen
doi : 10.1136/bjophthalmol-2020-316414
British Journal of Ophthalmology 2021;105:1645-1650
To compare the efficacy of compression sutures combined with intracameral air injection (CSAI) and thermokeratoplasty (TKP) for the management of acute corneal hydrops in keratoconus.
Ten-year outcomes of microkeratome-assisted lamellar keratoplasty for keratoconus
Angeli Christy Yu, Elena Franco, Lorenzo Caruso, James Myerscough, Rossella Spena, Fiorella Fusco, Sergiu Socea, Cristina Bovone, Massimo Busin
doi : 10.1136/bjophthalmol-2020-317253
British Journal of Ophthalmology 2021;105:1651-1655
To report the 10-year outcomes of modified microkeratome-assisted lamellar keratoplasty (LK) for keratoconus.
Evolution of corneal thickness and optical density after laser in situ keratomileusis versus small incision lenticule extraction for myopia correction
Jorge Luis Alio del Barrio, Alberto Parafita-Fernandez, Mario Canto-Cerdan, Jorge L Alio, Miguel Teus
doi : 10.1136/bjophthalmol-2020-316601
British Journal of Ophthalmology 2021;105:1656-1660
To compare the thickness and stromal optical density (OD) evolution of the flap and cap after femtosecond (FS-LASIK; Visumax) and small incision lenticule extraction (SMILE), respectively, for myopia correction.
Accuracy of common IOL power formulas in 611 eyes based on axial length and corneal power ranges
Veronika Röggla, Achim Langenbucher, Christina Leydolt, Daniel Schartmüller, Luca Schwarzenbacher, Claudette Abela-Formanek, Rupert Menapace
doi : 10.1136/bjophthalmol-2020-315882
British Journal of Ophthalmology 2021;105:1661-1665
To provide clinical guidance on the use of intraocular lens (IOL) power calculation formulas according to the biometric parameters.
Efficacy and safety of oral valganciclovir in cytomegalovirus anterior uveitis with uncontrolled intraocular pressure
Mandy O M Wong, Amy H Y Yu, Carmen K M Chan
doi : 10.1136/bjophthalmol-2020-317044
British Journal of Ophthalmology 2021;105:1666-1671
While cytomegalovirus (CMV) anterior uveitis (AU) patients often require glaucoma surgery, the effectiveness of systemic anti-viral in long-term intraocular pressure (IOP) control is not well established. Our study aims to identify the 2-year efficacy and safety of oral valganciclovir in CMV AU with uncontrolled IOP.
Association between esodeviation and primary open-angle glaucoma: the 2010–2011 Korea National Health and Nutrition Examination Survey
Jin-soo Kim, Young Kook Kim, Yong Woo Kim, Sung Uk Baek, Ahnul Ha, Jinho Lee, Haeng-Jin Lee, Dai Woo Kim, Jin Wook Jeoung, Seong-Joon Kim, Ki Ho Park
doi : 10.1136/bjophthalmol-2020-316901
British Journal of Ophthalmology 2021;105:1672-1677
To evaluate the association between strabismus and primary open-angle glaucoma (POAG) in a representative Korean population.
Prevalence, risk factors and management of ocular hypertension or glaucoma in patients with Vogt-Koyanagi-Harada disease
Peizeng Yang, Chaokui Wang, Guannan Su, Su Pan, Yang Qin, Jun Zhang, Qingfeng Cao, Zhenyu Zhong, Chunjiang Zhou, Yao Wang, Aize Kijlstra
doi : 10.1136/bjophthalmol-2020-316323
British Journal of Ophthalmology 2021;105:1678-1682
This study was performed to examine the prevalence, risk factors and treatment outcome of OHT/glaucoma in Chinese patients with Vogt-Koyanagi-Harada (VKH).
Risk of newly developing visual field defect and neurodegeneration after pars plana vitrectomy for idiopathic epiretinal membrane
Kunihiko Akino, Norihiro Nagai, Kazuhiro Watanabe, Norimitsu Ban, Toshihide Kurihara, Atsuro Uchida, Hajime Shinoda, Kazuo Tsubota, Yoko Ozawa
doi : 10.1136/bjophthalmol-2020-317478
British Journal of Ophthalmology 2021;105:1683-1687
Pars plana vitrectomy (PPV) is widely performed in patients with idiopathic epiretinal membrane (iERM) to improve vision. Postoperative visual field defects (VFDs) have been previously reported. However, whether they occur when using the most recent PPV system, and the frequency of VFDs as measured by standard automated perimetry, remain poorly documented and were examined in this study.
Ten-year survival trends of neovascular age-related macular degeneration at first presentation
Cristina Arpa, Hagar Khalid, Shruti Chandra, Siegfried Wagner, Katrin Fasler, Livia Faes, Pakinee Pooprasert, Reena Chopra, Gabriella Moraes, Konstantinos Balaskas, Pearse A Keane, Sobha Sivaprasad, Dun Jack Fu
doi : 10.1136/bjophthalmol-2020-317161
British Journal of Ophthalmology 2021;105:1688-1695
To describe 10-year trends in visual outcomes, anatomical outcomes and treatment burden of patients receiving antivascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD).
Visual acuity outcomes and anti-VEGF therapy intensity in macular oedema due to retinal vein occlusion: a real-world analysis of 15 613 patient eyes
Thomas Ciulla, John S Pollack, David F Williams
doi : 10.1136/bjophthalmol-2020-317337
British Journal of Ophthalmology 2021;105:1696-1704
To assess visual acuity (VA) outcomes and antivascular endothelial growth factor (anti-VEGF) therapy intensity in retinal vein occlusion (RVO)-related macular oedema (ME).
Increased risk of cancer in patients with retinal vein occlusion: a 12-year nationwide cohort study
Min Seok Kim, Joon Hee Cho, Seong Jun Byun, Chang-Mo Oh, Kyu Hyung Park, Sang Jun Park
doi : 10.1136/bjophthalmol-2020-316947
British Journal of Ophthalmology 2021;105:1705-1710
To investigate the association between incident retinal vein occlusion (RVO) and the subsequent development of cancer.
Presumed retinal pericapillary astrocytic hamartoma: multimodal imaging findings of a novel hamartomatous lesion
Gerardo Ledesma-Gil, Juliet Essilfie, Alex Onishi, Kenneth J Wald, Yale L Fisher, Amani A Fawzi, Carol L Shields, K Bailey Freund, Jay Chhablani
doi : 10.1136/bjophthalmol-2020-317670
British Journal of Ophthalmology 2021;105:1711-1715
To describe the multimodal imaging findings of retinal lesions that clinically resemble retinal astrocytic hamartomas (RAHs), but also have unique characteristics that we believe represent a novel variant.
T and genetic variations between Asian and Caucasian polypoidal choroidal vasculopathy
Janice Marie Jordan-Yu, Kelvin Teo, Qiao Fan, Jose Carlos Gana, Anna Karina Leopando, Sandrina Nunes, Cláudia Farinha, Patricia Barreto, Joana Barbosa Melo, Isabel Carreira, Joaquim Neto Murta, Rufino Silva, Chui Ming Gemmy Cheung
doi : 10.1136/bjophthalmol-2020-317537
British Journal of Ophthalmology 2021;105:1716-1723
To compare phenotypic and genetic variations in polypoidal choroidal vasculopathy (PCV) between Caucasian and Asian patients.
Incidence, timing and risk factors of type 1 retinopathy of prematurity in a North American cohort
Yinxi Yu, Lauren A Tomlinson, Gil Binenbaum, Gui-shuang Ying
doi : 10.1136/bjophthalmol-2020-317467
British Journal of Ophthalmology 2021;105:1724-1730
Early detection and timely treatment of type 1 retinopathy of prematurity (ROP) can reduce the risk of blindness. To evaluate the incidence, timing and risk factors of type 1 ROP in a large, broad-risk cohort of premature infants.
Prediabetes influences the structure of the macula: thinning of the macula in the Northern Finland Birth Cohort
JenniMaria Huru, Ilmari Leiviskä, Ville Saarela, M Johanna Liinamaa
doi : 10.1136/bjophthalmol-2020-317414
British Journal of Ophthalmology 2021;105:1731-1737
The aim of this study was to evaluate the effect of prediabetes and diabetes on macular thickness and retinal vascular calibres in our population-based cohort (Northern Finland Birth Cohort).
Overcoming barriers of retinal care delivery during a pandemic—attitudes and drivers for the implementation of digital health: a global expert survey
Livia Faes, Amir Rosenblatt, Roy Schwartz, Sara Touhami, Camila V Ventura, Irini P Chatziralli, Jorge Ruiz-Medrano, Denise Vogt, Alfonso Savastano, Humberto Ruiz-Garcia, Dominika Pohlmann, Anat Loewenstein
doi : 10.1136/bjophthalmol-2020-316882
British Journal of Ophthalmology 2021;105:1738-1743
The SARS-CoV-2 pandemic has imposed barriers to retinal care delivery worldwide. In this context, retinal services are exploring novel ways to ensure access to healthcare.
Choroidal thickness predicts progression of myopic maculopathy in high myopes: a 2-year longitudinal study
Zhixi Li, Wei Wang, Ran Liu, Decai Wang, Jian Zhang, Ou Xiao, Xinxing Guo, Monica Jong, Padmaja Sankaridurg, Kyoko Ohno-Matsui, Mingguang He
doi : 10.1136/bjophthalmol-2020-316866
British Journal of Ophthalmology 2021;105:1744-1750
To prospectively determine the impact of choroidal thickness (CT) on the myopic maculopathy progression.
Association of polymorphisms in ZFHX1B, KCNQ5 and GJD2 with myopia progression and polygenic risk prediction in children
Li Jia Chen, Fen Fen Li, Shi Yao Lu, Xiu Juan Zhang, Ka Wai Kam, Shu Min Tang, Pancy OS Tam, Wilson WK Yip, Alvin L Young, Clement C Tham, Chi Pui Pang, Jason C Yam
doi : 10.1136/bjophthalmol-2020-318708
British Journal of Ophthalmology 2021;105:1751-1757
To assess the association of single-nucleotide polymorphisms (SNPs) with myopia progression for polygenic risk prediction in children.
Gaze-evoked deformations of the optic nerve head in thyroid eye disease
Liam K Fisher, Xiaofei Wang, Tin A Tun, Hsi-Wei Chung, Dan Milea, Michael J A Girard
doi : 10.1136/bjophthalmol-2020-318246
British Journal of Ophthalmology 2021;105:1758-1764
To assess gaze evoked deformations of the optic nerve head (ONH) in thyroid eye disease (TED), using computational modelling and optical coherence tomography (OCT).
Call for emergency action to limit global temperature increases, restore biodiversity and protect health
Lukoye Atwoli, Abdullah H Baqui, Thomas Benfield, Raffaella Bosurgi, Fiona Godlee, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Carlos Augusto Monteiro, Ian Norman, Kirsten Patrick, Nigel Praities, Marcel GM Olde Rikkert, Eric J Rubin, Peush Sahni, Richard Smith, Nicholas J Talley, Sue Turale, Damián Vázquez
doi : 10.1136/bjophthalmol-2021-320290
British Journal of Ophthalmology 2021;105:e2
Correction: Thirty-five-year trend in the prevalence of refractive error in Austrian conscripts based on 1.5 million participants
doi : 10.1136/bjophthalmol-2019-315024corr1
British Journal of Ophthalmology 2021;105:e3
