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Highlights from this issue
Frank Larkin
doi : 10.1136/bjophthalmol-2021-319146
British Journal of Ophthalmology 2021;105:i-ii.
Success and succession
Frank Larkin
doi : 10.1136/bjophthalmol-2021-319027
British Journal of Ophthalmology 2021;105:445.
Modern approach to the treatment of dry eye, a complex multifactorial disease: a P.I.C.A.S.S.O. board review
Pasquale Aragona/Giuseppe Giannaccare/Rita Mencucci/Pierangela Rubino/Emilia Cantera/Maurizio Rolando
doi : 10.1136/bjophthalmol-2019-315747
British Journal of Ophthalmology 2021;105:446-453.
Dry eye disease (DED) is a growing public health concern affecting quality of life and visual function, with a significant socio-economic impact. It is characterised by the loss of homoeostasis, resulting in tear film instability, hyperosmolarity and inflammation of the ocular surface. If the innate immune response is unable to cope with internal bodily or environmental adverse conditions, the persistent, self-maintaining vicious circle of inflammation leads to the chronic form of the disease. Treatment of DED should be aimed at the restoration of the homoeostasis of the ocular surface system. A proper diagnostic approach is fundamental to define the relevance and importance of each of the DED main pathogenic factors, namely tear film instability, epithelial damage and inflammation. Consideration also needs to be given concerning two other pathogenic elements: lid margin changes and nerve damage. All the factors that maintain the vicious circle of DED in the patient’s clinical presentation have to be considered and possibly treated simultaneously. The treatment should be long-lasting and personalised since it has to be adapted to the different clinical conditions observed along the course of the disease. Since DED treatment is frequently unable to provide fast and complete relief from symptoms, empathy with patients and willingness to explain to them the natural history of the disease are mandatory to improve patients’ compliance. Furthermore, patients should be instructed about the possible need to increase the frequency and/or change the type of treatment according to the fluctuation of symptoms, following a preplanned rescue regimen.
Evolution of therapies for the corneal endothelium: past, present and future approaches
Hon Shing Ong/Marcus Ang/ Jodhbir Mehta
doi : 10.1136/bjophthalmol-2020-316149
British Journal of Ophthalmology 2021;105:454-467.
Corneal endothelial diseases are leading indications for corneal transplantations. With significant advancement in medical science and surgical techniques, corneal transplant surgeries are now increasingly effective at restoring vision in patients with corneal diseases. In the last 15 years, the introduction of endothelial keratoplasty (EK) procedures, where diseased corneal endothelium (CE) are selectively replaced, has significantly transformed the field of corneal transplantation. Compared to traditional penetrating keratoplasty, EK procedures, namely Descemet’s stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK), offer faster visual recovery, lower immunological rejection rates, and improved graft survival. Although these modern techniques can achieve high success, there are fundamental impediments to conventional transplantations. A lack of suitable donor corneas worldwide restricts the number of transplants that can be performed. Other barriers include the need for specialized expertise, high cost, and risks of graft rejection or failure. Research is underway to develop alternative treatments for corneal endothelial diseases, which are less dependent on the availability of allogeneic tissues – regenerative medicine and cell-based therapies. In this review, an overview of past and present transplantation procedures used to treat corneal endothelial diseases are described. Potential novel therapies that may be translated into clinical practice will also be presented.
Myopia in school-aged children with preterm birth: the roles of time spent outdoors and serum vitamin D
Hung-Da Chou/Tsung-Chieh Yao/Yu-Shu Huang/Chung-Ying Huang/Men-Ling Yang/Ming-Hui Sun/Hung-Chi Chen/Chun-Hsiu Liu/Shih-Ming Chu/Jen-Fu Hsu/ /Kuan-Jen Chen/Yih-Shiou Hwang/Chi-Chun Lai/Wei-Chi Wu
doi : 10.1136/bjophthalmol-2019-315663
British Journal of Ophthalmology 2021;105:468-472.
To analyse the factors associated with myopia in school-aged children with preterm birth and with or without retinopathy of prematurity (ROP).
Outcomes of the Boston type 1 and the Aurolab keratoprosthesis in eyes with limbal stem cell deficiency
Swapna S Shanbhag/Sirisha Senthil/Ashik Mohamed/Sayan Basu
doi : 10.1136/bjophthalmol-2020-316369
British Journal of Ophthalmology 2021;105:473-478.
To analyse the outcomes of keratoprosthesis in eyes with limbal stem cell deficiency (LSCD) and to compare the outcomes in two different keratoprosthesis devices.
Corneal endothelium in paediatric patients with uveitis: a prospective longitudinal study
Sheung Man Fung1/Ali El Hamouly/Hamza Sami/Dishay Jiandani/Sara Williams/Nasrin Tehrani/Kamiar Mireskandari/Asim Ali
doi : 10.1136/bjophthalmol-2020-316120
British Journal of Ophthalmology 2021;105:479-483.
To study the longitudinal effect of anterior chamber inflammation on the corneal endothelium in children.
Comparison of 13 formulas for IOL power calculation with measurements from partial coherence interferometry
Giacomo Savini/Marco Di Maita/Kenneth J Hoffer/Kristian N?ser/Domenico Schiano-Lomoriello/Aldo Vagge/Luca Di Cello/Carlo E Traverso
doi : 10.1136/bjophthalmol-2020-316193
British Journal of Ophthalmology 2021;105:484-489.
To compare the accuracy of 13 formulas for intraocular lens (IOL) power calculation in cataract surgery.
Accuracy of optical coherence tomography for diagnosing glaucoma: an overview of systematic reviews
Manuele Michelessi/Tianjing Li/Alba Miele/Augusto Azuara-Blanco/Riaz Qureshi/Gianni Virgili
doi : 10.1136/bjophthalmol-2020-316152
British Journal of Ophthalmology 2021;105:490-495.
To assess the diagnostic accuracy (DTA) of optical coherence tomography (OCT) for detecting glaucoma by systematically searching and appraising systematic reviews (SRs) on this issue.
SD-OCT peripapillary nerve fibre layer and ganglion cell complex parameters in glaucoma: principal component analysis
Marta Pazos/Marc Biarnés/Andrés Blasco-Alberto/Agnieszka Dyrda/Miguel ?ngel Luque-Fern?ndez/Alicia G?mez/Clara Mora/Elena Milla1/M?Jes?s Muniesa/Alfonso Ant?n/Valent?n Tinguaro D?az-Alem?n
doi : 10.1136/bjophthalmol-2020-316296
British Journal of Ophthalmology 2021;105:496-501.
To identify objective glaucoma-related structural features based on peripapillary (p) and macular (m) spectral domain optical coherence tomography (SD-OCT) parameters and assess their discriminative ability between healthy and glaucoma patients.
Factors associated with blindness three months following treatment for acute primary angle glaucoma
Shuning Li/Guangxian Tang/Su Jie Fan/Gang Zhai/Jianhua Lv/Hengli Zhang/Wensheng Lu/Jing Jiang/Aiguo Lv/Ningli Wang/Kai Cao/Jing Zhao/Vivian Vu/Dapeng Mu/Xiaohua Pan/Hui Feng/Yen C Hsia/Ying Han
doi : 10.1136/bjophthalmol-2020-316259
British Journal of Ophthalmology 2021;105:502-506.
To study the risk factors associated with blindness after treatment of acute primary angle closure (APAC), and to identify the critical time window to decrease rate of blindness.
Deep learning model to predict visual field in central 10° from optical coherence tomography measurement in glaucoma
Yohei Hashimoto/Ryo Asaoka/Taichi Kiwaki/Hiroki Sugiura/Shotaro Asano/Hiroshi Murata/Yuri Fujino/Masato Matsuura/Atsuya Miki/Kazuhiko Mori/Yoko Ikeda/Takashi Kanamoto/Junkichi Yamagami/Kenji Inoue/Masaki Tanito/Kenji Yamanishi
doi : 10.1136/bjophthalmol-2019-315600
British Journal of Ophthalmology 2021;105:507-513.
To train and validate the prediction performance of the deep learning (DL) model to predict visual field (VF) in central 10° from spectral domain optical coherence tomography (SD-OCT).
Efficacy and safety of selective laser trabeculoplasty and pattern scanning laser trabeculoplasty: a randomised clinical trial
Mandy Oi Man Wong/Isabel SW Lai/Poemen Puiman Chan/Noel CY Chan/Alison YY Chan/Gilda WK Lai/Vivian SM Chiu1/XChristopher Kai-Shun Leung
doi : 10.1136/bjophthalmol-2020-316178
British Journal of Ophthalmology 2021;105:514-520.
To compare the intraocular pressure (IOP) lowering effect and safety profile between pattern scanning laser trabeculoplasty (PSLT) and selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) over a 12-month follow-up.
Comparison of outcomes between Aurolab aqueous drainage implant placed in the superotemporal versus inferonasal quadrant
George Varghese Puthuran/Paul Frederic Palmberg/Hiruni Kaushalya Wijesinghe/Thandra Sai Shreya/S R Krishnadas/Steven J Gedde/Alan L Robin
doi : 10.1136/bjophthalmol-2019-315558
British Journal of Ophthalmology 2021;105:521-525.
To determine the outcomes of Aurolab aqueous drainage implant (AADI) placed in the superotemporal versus the inferonasal quadrant in adult eyes with refractory glaucoma.
Microaneurysms visualisation using five different optical coherence tomography angiography devices compared to fluorescein angiography
Salvatore Parrulli/Mariano Cozzi/Davide Monteduro/Federico Zicarelli/Giovanni Staurenghi
doi : 10.1136/bjophthalmol-2020-316817
British Journal of Ophthalmology 2021;105:526-530.
To compare fluorescein angiography (FA) and five different optical coherence tomography angiography (OCTA) devices and to test their reproducibility in the evaluation of retinal microaneurysms (MAs) secondary to diabetic retinopathy (DR).
Characteristics of myopic traction maculopathy in myopic Singaporean adults
Saiko Matsumura/Charumathi Sabanayagam/Chee Wai Wong/Chuen-Seng Tan/Anthony Kuo/Yee Ling Wong/Kyoko Ohno-Matsui/Tien Yin Wong/Ching-Yu Cheng/Quan V Hoang/Seang Mei Saw
doi : 10.1136/bjophthalmol-2020-316182
British Journal of Ophthalmology 2021;105:531-537.
To investigate the characteristics, risk factors and visual impact of myopic traction maculopathy (MTM) among adults with myopia in Singapore.
Association of alcohol intake with incidence and progression of diabetic retinopathy
Preeti Gupta/Eva K Fenwick/Charumathi Sabanayagam/Alfred Tau Liang Gan/XYih-Chung Tham/Sahil Thakur/Ryan Eyn Kidd Man/Paul Mitchell/Tien Yin Wong/Ching-Yu Cheng/Ecosse Luc Lamoureux
doi : 10.1136/bjophthalmol-2020-316360
British Journal of Ophthalmology 2021;105:538-542.
We examined the longitudinal association of baseline alcohol intake and frequency with the 6-year incidence and progression of diabetic retinopathy (DR) in a population-based cohort of Singaporean Indians.
Cardiovascular risk in patients receiving ranibizumab for exudative age-related macular degeneration: a nationwide self-controlled case-series study
Ha-Lim Jeon/Seong Jun Byun/Nicole L Pratt/Janet Sultana/Sang Jun Park/Ju-Young Shin
doi : 10.1136/bjophthalmol-2020-316373
British Journal of Ophthalmology 2021;105:543-548.
To identify the association between ranibizumab and risk of stroke and acute myocardial infarction (AMI) in patients with exudative age-related macular degeneration (AMD).
Real world evidence on 5661 patients treated for macular oedema secondary to branch retinal vein occlusion with intravitreal anti-vascular endothelial growth factor, intravitreal dexamethasone or macular laser
Richard Gale/Maria Pikoula/Aaron Y Lee/Spiros Denaxas/Catherine Egan/Adnan Tufail/Paul Taylor/UK EMR Users Group
doi : 10.1136/bjophthalmol-2020-315836
British Journal of Ophthalmology 2021;105:549-554.
Clinical trials suggest anti-vascular endothelial growth factor is more effective than intravitreal dexamethasone as treatment for macular oedema secondary to branch retinal vein occlusion. This study asks if ‘real world’ data from a larger and more diverse population, followed for a longer period, also support this conclusion.
Analysis of choriocapillaris perfusion and choroidal layer changes in patients with chronic central serous chorioretinopathy randomised to micropulse laser or photodynamic therapy
Mary Ho/Frank Hiu Ping Lai/Danny Siu Chun Ng/Lawrence Pui Leung Iu/Li Jia Chen/Andrew Chun Yue Mak/Yolanda Yip/Carol Cheung/Alvin Lerrmann Young/Marten Brelen
doi : 10.1136/bjophthalmol-2020-316076
British Journal of Ophthalmology 2021;105:555-560.
The purpose of this study was to investigate the signal changes in choriocapillaris flow deficits and choroidal thickness changes using swept-source optical coherence tomography angiography (OCTA) following different treatments.
Automated diagnoses of age-related macular degeneration and polypoidal choroidal vasculopathy using bi-modal deep convolutional neural networks
Zhiyan Xu/Weisen Wang/Jingyuan Yang/Jianchun Zhao/Dayong Ding//Feng He/Di Chen/Zhikun Yang/Xirong Li/Weihong Yu/Youxin Chen
doi : 10.1136/bjophthalmol-2020-315817
British Journal of Ophthalmology 2021;105:561-566.
To investigate the efficacy of a bi-modality deep convolutional neural network (DCNN) framework to categorise age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) from colour fundus images and optical coherence tomography (OCT) images.
Choroidal luminal and stromal areas and choriocapillaris perfusion are characterised by a non-linear quadratic relation in healthy eyes
Enrico Borrelli/Maria Cristina Gabela/Riccardo Sacconi/Lea Querques/Giovanna Vella/Biancamaria Zuccaro/Francesco Gelormini/Francesco Bandello/Giuseppe Querques
doi : 10.1136/bjophthalmol-2020-316479
British Journal of Ophthalmology 2021;105:567-572.
To assess the associations among different optical coherence tomography (OCT) structural and angiography quantitative metrics used to characterise the choroid in healthy subjects.
Incidence and phenotypical variation of outer retina-associated hyperreflectivity in macular telangiectasia type 2
Stefanie Mueller/Frederic Gunnemann/Kai Rothaus/Marius Book/Henrik Faatz/Alan Bird/Daniel Pauleikhoff
doi : 10.1136/bjophthalmol-2020-317997
British Journal of Ophthalmology 2021;105:573-576.
Macular telangiectasia type 2 (MacTel) is a neurodegenerative disease resulting in photoreceptor loss. Optical coherence tomography (OCT) reveals outer retina-associated hyperreflectivity (ORaH) as part of this process. The purpose of this study was to describe the incidence and phenotypical variation of ORaH.
Comparison of widefield swept-source optical coherence tomography angiography with ultra-widefield colour fundus photography and fluorescein angiography for detection of lesions in diabetic retinopathy
Ying Cui/Ying Zhu/Jay C Wang/Yifan Lu/Rebecca Zeng/Raviv Katz/Filippos Vingopoulos/Rongrong Le/Inês La?ns/David M Wu/Dean Eliott/Demetrios G Vavvas/Deeba Husain1/Joan W Miller/Leo A Kim/John B Miller
doi : 10.1136/bjophthalmol-2020-316245
British Journal of Ophthalmology 2021;105:577-581.
To compare widefield swept-source optical coherence tomography angiography (WF SS-OCTA) with ultra-widefield colour fundus photography (UWF CFP) and fluorescein angiography (UWF FA) for detecting diabetic retinopathy (DR) lesions.
Nuclear expression of BAP-1 in transvitreal incisional biopsies and subsequent enucleation of eyes with posterior choroidal melanoma
Christina Herrspiegel/Anders Kvanta/Emma Lardner/Louise Ramsk?ld Cabaca/Jill Wells/Katarina Bartuma/Stefan Seregard/Gustav St?lhammar
doi : 10.1136/bjophthalmol-2020-316498
British Journal of Ophthalmology 2021;105:582-586.
As a majority of patients with choroidal melanoma do not undergo enucleation, tumour tissue for prognostic testing has to be obtained with alternate methods. Transvitreal incisional biopsies enable histological examination as well as immunohistochemical staining of BRCA1-associated protein-1 (BAP-1).
Heterogeneity of GNAQ/11 mutation inversely correlates with the metastatic rate in uveal melanoma
Chen Liang/Lan ya Peng/Ming Zou/Xuemei Chen/Yingying Chen/Hou Chen/Lirong Xiao/Naihong Yan/Junjun Zhang/Qing Zhao/Xi Huang
doi : 10.1136/bjophthalmol-2019-314867
British Journal of Ophthalmology 2021;105:587-592.
To determine whether the GNAQ/11 mutation correlated with the outcome of patients with uveal melanoma (UM) when genetic heterogeneity was considered.
