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Highlights from this issue
Keith Barton/James Chodosh/Jost B Jonas/Editors in Chief
doi : 10.1136/bjophthalmol-2021-319015
British Journal of Ophthalmology 2021;105:i-ii.
Fluid-based prognostication in n-AMD: Type 3 macular neovascularisation needs an analysis in isolation
Ashish Sharma/Nikulaa Parachuri/Nilesh Kumar/Francesco Bandello/Baruch D Kuppermann/Anat Loewenstein/Carl Regillo/Usha Chakravarthy
doi : 10.1136/bjophthalmol-2020-318128
British Journal of Ophthalmology 2021;105:297-298.
Medical treatment in thyroid eye disease in 2020
Jwu Jin Khong/Alan McNab
doi : 10.1136/bjophthalmol-2020-316051
British Journal of Ophthalmology 2021;105:299-305.
Thyroid eye disease (TED) affects 25% of patients with Graves’ hyperthyroidism, where 1 in 20 patients has active, moderate-to-severe disease that will require medical treatment for reducing TED activity and severity. Intravenous corticosteroid has been the mainstay of treatment for active moderate-to-severe TED. With improved understanding of the pathophysiology of TED, immunotherapy targeting different molecular pathways including T cells, B cells, cytokines and cell surface receptors have been investigated in randomised clinical trials. This review provides an overview of the current advances in medical treatment including teprotumumab, tocilizumab, rituximab and mycophenolate and the indications for their use in the management of active, moderate-to-severe TED.
COVID-19 and immunosuppression: a review of current clinical experiences and implications for ophthalmology patients taking immunosuppressive drugs
Zheng Xian Thng/Marc D De Smet/Cecilia S Lee/Vishali Gupta/Justine R Smith/Peter J McCluskey/Jennifer E Thorne/John H Kempen/Manfred Zierhut/Quan Dong Nguyen/Carlos Pavesio/Rupesh Agrawal
doi : 10.1136/bjophthalmol-2020-316586
British Journal of Ophthalmology 2021;105:306-310.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019 in Wuhan city, Hubei province, China. This is the third and largest coronavirus outbreak since the new millennium after SARS in 2002 and Middle East respiratory syndrome (MERS) in 2012. Over 3?million people have been infected and the COVID-19 has caused more than 217 000 deaths. A concern exists regarding the vulnerability of patients who have been treated with immunosuppressive drugs prior or during this pandemic. Would they be more susceptible to infection by the SARS-CoV-2 and how would their clinical course be altered by their immunosuppressed state? This is a question the wider medical fraternity—including ophthalmologists, rheumatologists, gastroenterologist and transplant physicians among others—must answer. The evidence from the SARS and MERS outbreak offer some degree of confidence that immunosuppression is largely safe in the current COVID-19 pandemic. Preliminary clinical experiences based on case reports, small series and observational studies show the morbidity and mortality rates in immunosuppressed patients may not differ largely from the general population. Overwhelmingly, current best practice guidelines worldwide recommended the continuation of immunosuppression treatment in patients who require them except for perhaps high-dose corticosteroid therapy and in patients with associated risk factors for severe COVID-19 disease.
Using incognito standardised patients to evaluate quality of eye care in China
Jingchun Nie/Lifang Zhang/Jiayuan Gao/ Jason Li/Qian Zhou/Yaojiang Shi/Sean Sylvia/Nathan Congdon
doi : 10.1136/bjophthalmol-2019-315103
British Journal of Ophthalmology 2021;105:311-316.
Few studies have objectively examined the quality of eye care in China. We assessed refractive care using the incognito standardised patient (SP) approach, a gold standard for evaluating clinical practice.
Epidemiology of 2000 Chinese uveitis patients from Northeast China
Tianyu Hao/LI Yang/Bowen Li/Xiangtong Chen/Dongchen Li/Xiaoli Liu
doi : 10.1136/bjophthalmol-2020-316256
British Journal of Ophthalmology 2021;105:317-321.
To study the clinical characteristics of 2000 patients with uveitis admitted to the ophthalmology centre of the Second Hospital of Jilin University.
Intraocular leucocyte subpopulations analysis by multiparametric flow cytometry in human uveitis
Ester Carre?o/Cristina Serrano/Nelida Mu?oz/Fredeswinda Romero-Bueno/Olga S?nchez Pernaute/Nicolas Alejandre
doi : 10.1136/bjophthalmol-2019-315511
British Journal of Ophthalmology 2021;105:322-327.
Purpose The aim of this study was to describe the cellular infiltrate in aqueous and vitreous samples of patients with uveitis analysed by multiparametric flow cytometry.
12-year analysis of incidence, microbiological profiles and in vitro antimicrobial susceptibility of infectious keratitis: the Nottingham Infectious Keratitis Study
Darren Shu Jeng Ting/Charlotte Shan Ho/Jessica Cairns/Ahmad Elsahn/Mouhamed Al-Aqaba/Tim Boswell/Dalia Gsaid/Harminder Singh Dua
doi : 10.1136/bjophthalmol-2020-316128
British Journal of Ophthalmology 2021;105:328-333.
Background/aims To examine the incidence, causative microorganisms and in vitro antimicrobial susceptibility and resistance profiles of infectious keratitis (IK) in Nottingham, UK.
Presentation, surgery and 1-year outcomes of childhood cataract surgery in Tanzania
Furahini Godfrey Mndeme/Blandina Theophyl Mmbaga/Mchikirwa Msina/Judith Mwende/Sonia J Vaitha/Min J Kim/David Macleod/Matthew J Burton/Clare E Gilbert/Richard Bowman
doi : 10.1136/bjophthalmol-2020-316042
British Journal of Ophthalmology 2021;105:334-340.
Recent reports have suggested a significant change in the causes of blindness in children in low-income countries cataract becoming the leading cause. We aimed to investigate the presentations and surgical outcomes in children with cataract operated at different ages in Tanzania.
Novel p.G1344E mutation in FBN1 is associated with ectopia lentis
Yuan Yang/Ya-li Zhou/Teng-teng Yao/Hui Pan/Ping Gu/Zhao-yang Wang
doi : 10.1136/bjophthalmol-2019-315265
British Journal of Ophthalmology 2021;105:341-347.
Ectopia lentis refers to dislocation or subluxation of the crystalline lens. Fibrillin-1, encoded by FBN1, is an important microfibrillar structural component that is specifically required for the suspensory ligament of the lens. FBN1 mutations may cause abnormal structure of microfibrils and has been associated with a broad spectrum of clinical phenotypes. In this study, we characterised a Chinese dominant family with late-onset isolated ectopia lentis caused by a novel missense FBN1 mutation.
Long-term effect of YAG laser iridotomy on corneal endothelium in primary angle closure suspects: a 72-month randomised controlled study
Chimei Liao/Jian Zhang/Yuzhen Jiang/Shengsong Huang/Tin Aung/Paul J Foster/David Friedman/Mingguang He
doi : 10.1136/bjophthalmol-2020-315811
British Journal of Ophthalmology 2021;105:348-353.
To evaluate the effect of YAG laser peripheral iridotomy (LPI) on corneal endothelial cell density (ECD) and morphology in primary angle closure suspects (PACS) over 72 months.
Comparison of macular structural and vascular changes in neuromyelitis optica spectrum disorder and primary open angle glaucoma: a cross-sectional study
Xiayin Zhang/Hui Xiao/Chunxin Liu/Lanqin Zhao/Jinghui Wang/Haiquan Li/ Ruixin Wang/Yi Zhu/Chuan Chen/Xiaohang Wu/Duoru Lin/Jingqi Wang/Xing Liu/Wei Qiu/Patrick Yu-Wai-Man/Daniel S Ting/Haotian Lin
doi : 10.1136/bjophthalmol-2020-315842
British Journal of Ophthalmology 2021;105:354-360.
To compare macular structure and vasculature between neuromyelitis optica spectrum disorder (NMOSD) and primary open angle glaucoma (POAG) using optical coherence tomography angiography.
Morphological characteristics of parapapillary atrophy and subsequent visual field progression in primary open-angle glaucoma
Ahnul Ha/Yong Woo Kim/Jinho Lee/ Eunoo Bak/Young Soo Han/Young Kook Kim/Ki Ho Park/Jin Wook Jeoung
doi : 10.1136/bjophthalmol-2019-315477
British Journal of Ophthalmology 2021;105:361-366.
To investigate the associations between the morphological characteristics of beta-zone parapapillary atrophy (?-zone PPA) and subsequent visual field (VF) progression in eyes with primary open-angle glaucoma (POAG).
Determinants of lamina cribrosa depth in healthy Asian eyes: the Singapore Epidemiology Eye Study
Tin A Tun/Xiaofei Wang/Mani Baskaran/ Monisha EstherNongpiur/Yih Chung Tham/Duc Quang Nguyen/Nicholas G Strouthidis/Tin Aung/Ching-Yu Cheng/Craig Boote/Michael J A Girard
doi : 10.1136/bjophthalmol-2020-315840
British Journal of Ophthalmology 2021;105:367-373.
To investigate the determinants of lamina cribrosa depth (LCD) in healthy eyes of Chinese and Indian Singaporean adults.
Henle fibre layer haemorrhage: clinical features and pathogenesis
Caroline R Baumal/David Sarraf/Tara Bryant/Wei Gui/Nora Muakkassa/Francesco Pichi/Giuseppe Querques/Netan Choudhry/Mehmet Yasin Teke/Andrea Govetto/Alessandro Invernizzi/Dean Eliott/Alain Gaudric/Eduardo Cunha de Souza/Jonathan Naysan/Andrea Lembo/Grace C Lee/K Bailey Freund
doi : 10.1136/bjophthalmol-2019-315443
British Journal of Ophthalmology 2021;105:374-380.
To describe the clinical presentation and characteristic imaging features of deep retinal haemorrhages primarily located in the Henle fibre layer (HFL) of the macula. The spectrum of aetiologies and a comprehensive theory of pathogenesis are presented.
Rate of visual field decay in glaucomatous eyes with acquired pits of the optic nerve
Golnoush Mahmoudinezhad/Mark Lin/Alessandro Rabiolo/Esteban Morales/Pradtana Hirunpatravong/Farideh Sharifipour/Joseph Caprioli
doi : 10.1136/bjophthalmol-2020-315980
British Journal of Ophthalmology 2021;105:381-386.
To evaluate the relationship between the presence of an acquired pit of the optic nerve (APON) and the rate of visual field (VF) decay in primary open-angle glaucoma (POAG).
Weekly and seasonal changes of intraocular pressure measured with an implanted intraocular telemetry sensor
Kaweh Mansouri/Kevin Gillmann/Harsha Laxmana Rao/Robert N Weinreb
doi : 10.1136/bjophthalmol-2020-315970
British Journal of Ophthalmology 2021;105:387-391.
Background/Aims To better understand seasonal and weekday intraocular pressure (IOP) variations, long-term daily IOP measurements were assessed in patients with glaucoma using an intraocular telemetric sensor.
Correlation of ocular rigidity with intraocular pressure spike after intravitreal injection of bevacizumab in exudative retinal disease
Diane N Sayah/Andrei-Alexandru Szigiato/Javier Mazzaferr/Denise Descovich/Renaud Duval/Flavio A Rezende/Santiago Costantino/Mark R Lesk
doi : 10.1136/bjophthalmol-2019-315595
British Journal of Ophthalmology 2021;105:392-396.
To evaluate the non-invasive measurement of ocular rigidity (OR), an important biomechanical property of the eye, as a predictor of intraocular pressure (IOP) elevation after anti-vascular endothelial growth factor (anti-VEGF) intravitreal injection (IVI).
Factors affecting the diagnostic performance of circumpapillary retinal nerve fibre layer measurement in glaucoma
Damon Wong/Jacqueline Chua/ Mani Baskaran/Bingyao Tan/Xinwen Yao/Samuel Chan/Yih Chung Tham/Rachel Chong/Tin Aung/Ecosse Luc Lamoureux/Eranga N Vithana/Ching Yu Cheng/Leopold Schmetterer
doi : 10.1136/bjophthalmol-2020-315985
British Journal of Ophthalmology 2021;105:397-402.
To identify factors that influence the diagnostic performance of circumpapillary retinal nerve fibre layer (RNFL) thickness measurements in the detection of primary open-angle glaucoma (POAG).
iOCT-assisted macular hole surgery: outcomes and utility from the DISCOVER study
Philina Yee/Duriye Damla Sevgi/Joseph Abraham/Sunil K Srivastava/Thuy Le/Atsuro Uchida/Natalia Figueiredo/Aleksandra V Rachitskaya/Sumit Sharma/Jamie Reese/Justis P Ehlers
doi : 10.1136/bjophthalmol-2020-316045
British Journal of Ophthalmology 2021;105:403-409.
Background/aims This study aimed to characterise the clinical outcomes and utility of intraoperative optical coherence tomography (iOCT)-assisted macular hole (MH) repair.
Impact of contact versus non-contact wide-angle viewing systems on outcomes of primary retinal detachment repair (PRO study report number 5)
Marisa G. Tieger/Marianeli Rodriguez/Jay C. Wang/Anthony Obeid/Claire Ryan/Xinxiao Gao/Srividya Kakulavarapu/Patrick J. Mardis/Malika L. Madhava/Sean M. Maloney/Adam Z. Adika/Krishi V. Peddada/Kareem Sioufi/James A. Stefater/Nora J. Forbes/Antonio Capone Jr/Geoffrey G. Emerson/Daniel P. Joseph/Carl Regillo/Jason Hsu/Omesh Gupta/Dean Eliott/Edwin H. Ryan/Yoshihiro Yonekawa
doi : 10.1136/bjophthalmol-2020-315948
British Journal of Ophthalmology 2021;105:410-413.
Vitrectomy to repair retinal detachment is often performed with either non-contact wide-angle viewing systems or wide-angle contact viewing systems. The purpose of this study is to assess whether the viewing system used is associated with any differences in surgical outcomes of vitrectomy for primary non-complex retinal detachment repair.
Two-year interim safety results of the 0.2 µg/day fluocinolone acetonide intravitreal implant for the treatment of diabetic macular oedema: the observational PALADIN study
Sam E Mansour/Daniel F Kiernan/Daniel B Roth/David Eichenbaum/Nancy M Holekamp/Samer Kaba/Erica Werts
doi : 10.1136/bjophthalmol-2020-315984
British Journal of Ophthalmology 2021;105:414-419.
Background The 0.2 µg/day fluocinolone acetonide (FAc) implant delivers continuous, low-dose, intravitreal corticosteroid for the treatment of diabetic macular oedema (DMO). This ongoing, 3-year, observational clinical trial provides long-term, ‘real-world’ safety results for the FAc implant in DMO.
Role of socio-economic factors in visual impairment and progression of diabetic retinopathy
Jin Rong Low/Alfred Tau Liang Gan/Eva K Fenwick/Preeti Gupta/Tien Y Wong/Zhen Ling Teo/Sahil Thakur/Yih Chung Tham/Charumathi Sabanayagam/Ching-Yu Cheng/Ecosse Luc Lamoureux/Ryan Eyn Kidd Man
doi : 10.1136/bjophthalmol-2020-316430
British Journal of Ophthalmology 2021;105:420-425
To investigate the longitudinal associations between person-level and area-level socioeconomic status (PLSES and ALSES, respectively) with diabetic retinopathy (DR) and visual impairment (VI) in Asians with diabetes mellitus (DM).
Comparison of retinal vessel diameter measurements from swept-source OCT angiography and adaptive optics ophthalmoscope
Xinwen Yao/Mengyuan Ke/Yijie Ho/Emily Lin/Damon W K Wong/Bingyao Tan/Leopold Schmetterer/Jacqueline Chua
doi : 10.1136/bjophthalmol-2020-316111
British Journal of Ophthalmology 2021;105:426-431.
To compare the retinal vessel diameter measurements obtained from the swept-source optical coherence tomography angiography (OCTA; Plex Elite 9000, Carl Zeiss Meditec, USA) and adaptive optics ophthalmoscope (AOO; RTX1, Imagine Eyes, France).
Ten-year incidence and assessment of safe screening intervals for diabetic retinopathy: the OPHDIAT study
Chloé Chamard/Vincent Daien/Ali Erginay/ Jean-Francois Gautier/Max Villain/Ramin Tadayoni/Isabelle Carriere/Pascale Massin
doi : 10.1136/bjophthalmol-2020-316030
British Journal of Ophthalmology 2021;105:432-439.
To estimate the 10-year incidence of referable diabetic retinopathy (DR) in a French population with type 1 and 2 diabetes mellitus (DM). A secondary objective was the assessment of safe screening intervals in patients with diabetes without retinopathy.
Low-cost, smartphone-based frequency doubling technology visual field testing using a head-mounted display
Karam AlRahman Alawa/Ryan P Nolan/Elaine Han/Alejandro Arboleda/Heather Durkee/Mohamed S Sayed/Mariela C Aguilar/Richard K Lee
doi : 10.1136/bjophthalmol-2019-314031
British Journal of Ophthalmology 2021;105:440-444.
Current visual field screening machines are bulky and expensive, limiting their accessibility, affordability and use. We report the design and evaluation of a novel, portable, cost-effective system for glaucoma screening using smartphone-based visual field screening using frequency doubling technology (FDT) and a head-mounted display.
