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Is artificial intelligence a solution to the myopia pandemic?
Li Lian Foo, Marcus Ang, Chee Wai Wong, Kyoko Ohno-Matsui, Seang-Mei Saw, Tien Yin Wong, Daniel S Ting
doi : 10.1136/bjophthalmol-2021-319129
COVID-19 pandemic of 2020 has impacted all aspects of clinical practice in the UK. Cataract services suffered severe disruption due to necessary measures taken to reduce elective surgery in order to release capacity to support intensive care requirements. Faced with a potential 50% increase in cataract surgery workload per week in the post-COVID-19 world, eye units should use this event to innovate, not just survive but to also evolve for a sustainable future. In this article, we discuss the inadequacies of existing service rationing options to tackle the COVID-19 cataract backlog. This includes limiting rationing based on visual acuity, limiting surgery to first or only seeing eyes, and postponing clinic and surgical dates according to referral dates. We propose units use the lockdown time to reset and develop a comprehensive patient-centred care pathway using principles of value-based healthcare: the cataract integrated practice units. Developing an agile surgical database that incorporates all aspects of patient need from education to follow-up in their individual cataract journey will allow units to react and plan quickly in the early phase of recovery and beyond. We also discuss the considerations units should bear in mind on telemedicine, modifications for face-to-face clinics, theatre organisation and options of expanding cataract throughput capacity. The pause in elective surgery due to the pandemic may have provided cataract services a rare opportunity to reset and transform cataract service pathways for the digital era.
Cataract service redesign in the post-COVID-19 era
Pei-Fen Lin, Hasan Naveed, Maria Eleftheriadou, Robert Purbrick, Mehran Zarei Ghanavati, Christopher Liu
Photophobia: shared pathophysiology underlying dry eye disease, migraine and traumatic brain injury leading to central neuroplasticity of the trigeminothalamic pathway
Ryan J Diel, Divy Mehra, Randy Kardon, Dawn C Buse, Eric Moulton, Anat Galor
doi : 10.1136/bjophthalmol-2020-316417
Background Photophobia is a potentially debilitating symptom often found in dry eye disease (DE), migraine and traumatic brain injury (TBI).
Impact of spectacles wear on uncorrected visual acuity among urban migrant primary school children in China: a cluster-randomised clinical trial
Xinwu Zhang, Ming Zhou, Xiaochen Ma, Hongmei Yi, Haiqing Zhang, Xiuqin Wang, Ling Jin, Kovin Naidoo, Hasan Minto, Haidong Zou, Scott Rozelle, Nathan Congdon, Yue Ma
doi : 10.1136/bjophthalmol-2020-316213
Objective To estimate the effect of providing free spectacles on uncorrected visual acuity (VA) among urban migrant Chinese school children.
Prognostic factors for local recurrence and survival and impact of local treatments on survival in lacrimal gland carcinoma
Joshua Richard Ford, Maria Laura Rubin, Steven Jay Frank, Jing Ning, James Matthew Debnam, Diana Bell, Adel El-Naggar, Renata Ferrarotto, Bita Esmaeli
doi : 10.1136/bjophthalmol-2020-316142
Background/aims To identify prognostic factors for local recurrence, distant metastasis and disease-specific survival (DSS) for lacrimal gland carcinoma.
Invasive conjunctival melanoma mimicking ocular surface squamous neoplasia: a case series
Beatrice Gallo, Caroline Thaung, Gordon Hay, Amit K Arora, Victoria ML Cohen, Bertil Damato, Mandeep S Sagoo
doi : 10.1136/bjophthalmol-2019-315393
Background Conjunctival melanoma is the second most common conjunctival malignant tumour after squamous cell carcinoma, usually arising from primary acquired melanosis and less commonly from a conjunctival naevus or de novo. We report four cases of conjunctival melanoma masquerading as ocular surface squamous neoplasia.
Analysis of new cases of uveitis at academic and community settings
Meghan Berkenstock, Renuka Mopuru, Jennifer Thorne, Adrienne Willams Scott
doi : 10.1136/bjophthalmol-2020-316651
Purpose Describe the demographics of new patients with uveitis presenting to an urban, academic centre and affiliated, suburban satellite clinics to assess if changes in infrastructure were needed for clinical care. Secondarily, examine the frequency of infectious uveitides.
Effect of baseline test selection on glaucoma progression detection by optical coherence tomography-guided progression analysis
Dong Hyun Kang, Young Hoon Hwang
doi : 10.1136/bjophthalmol-2019-315715
Purpose To evaluate the effect of baseline test selection on progression detection of circumpapillary retinal nerve fibre layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) in glaucomatous eyes by optical coherence tomography (OCT)-guided progression analysis (GPA).
Defining glaucomatous optic neuropathy using objective criteria from structural and functional testing
Jayant Venkatramani Iyer, Michael V Boland, Joan Jefferys, Harry Quigley
doi : 10.1136/bjophthalmol-2020-316237
Background/Aims To identify objective criteria from optical coherence tomography (OCT) and perimetry that denote a useful, specific definition of glaucomatous optic neuropathy (GON) in eyes with open-angle glaucoma for comparisons among glaucoma research studies.
Primary photodynamic therapy for small amelanotic choroidal melanomas: consecutive case series of 69 patients with at least 24-month follow-up
Hibba Quhill, Daniel Gosling, Katharine Sears, Paul Rundle
doi : 10.1136/bjophthalmol-2020-316616
Aims To investigate the success and recurrence rates and visual outcomes in a large case series of amelanotic posterior choroidal melanomas treated by means of primary photodynamic therapy (PDT) with verteporfin.
The effect of posterior vitreous detachment on aflibercept response in diabetic macular oedema
Cemal ?zsaygili, Bekir Küçük, Yener Yildirim
doi : 10.1136/bjophthalmol-2020-316155
Purpose To investigate the effect of posterior vitreous detachment (PVD) on aflibercept response in treatment-naïve diabetic macular oedema (DME).
Knowledge, attitudes and eye health-seeking behaviours in a population-based sample of people with diabetes in rural China
Tingting Chen, Ling Jin, Wenhui Zhu, Congyao Wang, Guoshan Zhang, Xiuqin Wang, Jun Wang, Ke Yang, Gillian M Cochrane, Ecosse Luc Lamoureux, David S Friedman, Suzanne Gilbert, Van C Lansingh, Serge Resnikoff, Jialiang Zhao, Baixiang Xiao, Mingguang He, Nathan Congdon
doi : 10.1136/bjophthalmol-2020-316105
Aims To assess knowledge of diabetes and acceptance of eye care among people with diabetes in rural China, to improve service uptake.
Different effect of media opacity on automated and manual measurement of foveal avascular zone of optical coherence tomography angiographies
Jinyu Zhang, Fang Yao Tang, Carol Cheung, Xiaolin Chen, Haoyu Chen
doi : 10.1136/bjophthalmol-2019-315780
Background Optical coherence tomography angiography (OCTA) provides not only visualisation but also quantitative measurement of foveal avascular zone (FAZ). Media opacity is common in elderly subjects with cataracts. This study aimed to investigate the impact of media opacity on automated and manual FAZ measurement.
Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study
Qian Yang, Xiaohong Zhou, Yingqin Ni, Haidong Shan, Wenjing Shi, Xuelei Yin, Jiangqin Liu, Xin Huang
doi : 10.1136/bjophthalmol-2020-316401
Purposes To develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).
Peripheral extent of the choroidal circulation by ultra-widefield indocyanine green angiography in healthy eyes
Aditya Verma, Jyotsna Maram, Ahmed Roshdy Alagorie, Jano van Hemert, Darren J Bell, Michael Singer, Dana Keane, Jessica Carnevale, Muneeswar Nittala, SriniVas Sadda
doi : 10.1136/bjophthalmol-2020-316412
Aim To analyse the peripheral extent of choroidal circulation using ultra-widefield (UWF) indocyanine green angiography (ICGA) in healthy eyes.
Long-term safety and tolerability of subretinal transplantation of embryonic stem cell-derived retinal pigment epithelium in Asian Stargardt disease patients
Youngje Sung, Min Ji Lee, Jinjung Choi, Sang Yoon Jung, So Young Chong, Jung Hoon Sung, Sung Han Shim, Won Kyung Song
doi : 10.1136/bjophthalmol-2020-316225
Background Although human embryonic stem cells (hESCs) have been considered a potential therapeutic option for regenerative medicine, there are some concerns regarding tumorigenicity, immunogenicity and ethical considerations. Stargardt macular dystrophy (SMD) is the most common form of juvenile macular degeneration that causes early onset blindness. Therapeutic options for SMD remain limited, although several treatment strategies are currently under investigation. Here, we report a 3-year assessment of a phase I clinical trial involving subretinal transplantation of hESC-retinal pigment epithelium (RPE) cells in patients with SMD.
A sialidosis type I cohort and a quantitative approach to multimodal ophthalmic imaging of the macular cherry-red spot
Malena Daich Varela, Wadih M Zein, Camilo Toro, Catherine Groden, Jean Johnston, Laryssa A Huryn, Alessandra d’Azzo, Cynthia J Tifft, Edmond J FitzGibbon
doi : 10.1136/bjophthalmol-2020-316826
Aim To describe the ophthalmologic findings on the largest cohort of patients with sialidosis type I due to deficiency of the lysosomal sialidase, neuraminidase 1 (NEU1) and to introduce a quantitative neuroretinal image analysis approach to the associated ‘macular cherry-red spot’.
Optimal fluence rate of photodynamic therapy for chronic central serous chorioretinopathy
Dong-Geun Park, Seongyong Jeong, Donghyoun Noh, Min Sagong
doi : 10.1136/bjophthalmol-2020-316837
Aims To investigate the lowest effective fluence rate of photodynamic therapy (PDT) for treating chronic central serous chorioretinopathy (CSC).
Thinner retinal nerve fibre layer in young adults with foetal alcohol spectrum disorders
Emelie Gyllencreutz, Eva Aring, Valdemar Landgren, Magnus Landgren, Marita Andersson Gronlund
doi : 10.1136/bjophthalmol-2020-316506
Background/Aims Ophthalmological abnormalities such as ptosis, strabismus, refractive errors and optic nerve hypoplasia have been reported in foetal alcohol spectrum disorders (FASD). The purpose of this study was to investigate whether retinal thickness, retinal nerve fibre layer (RNFL) and optic disc area (ODA) differ between individuals with FASD and healthy controls.
Classification of pachychoroid disease on ultrawide-field indocyanine green angiography using auto-machine learning platform
In Ki Kim, Kook Lee, Jae Hyun Park, Jiwon Baek, Won Ki Lee
doi : 10.1136/bjophthalmol-2020-316108
Aims Automatic identification of pachychoroid maybe used as an adjunctive method to confirm the condition and be of help in treatment for macular diseases. This study investigated the feasibility of classifying pachychoroid disease on ultra-widefield indocyanine green angiography (UWF ICGA) images using an automated machine-learning platform.
Peripapillary vessel parameters and mean ocular perfusion pressure in young healthy eyes: OCT angiography study
Young In Yun, Yong Woo Kim, Hyung Bin Lim, Dong Hyun Lee, Ji Hong Kim, Baek-Lok Oh, Jin Wook Jeoung, Ki Ho Park
doi : 10.1136/bjophthalmol-2020-316222
Background To investigate the relationship between estimated mean ocular perfusion pressure (MOPP) and peripapillary perfusion density (PD) or vessel density (VD) as measured by spectral-domain optical coherence tomography angiography (OCTA) in young healthy eyes.
Genotype–phenotype correlation and interaction of 4q25, 15q14 and MIPEP variants with myopia in southern Chinese population
Junbin Liu, Riping Zhang, Lixia Sun, Yuqian Zheng, Shaowan Chen, Shao-Lang Chen, Yanxuan Xu, Chi-Pui Pang, Mingzhi Zhang, Tsz Kin Ng
doi : 10.1136/bjophthalmol-2019-314782
Background/aims To determine the association and interaction of genome-wide association study-reported variants for Asian populations with myopia and ocular biometric parameters in southern Chinese population.
Conjunctival intraepithelial neoplasia and carcinoma: distinct clinical and histological features in relation to human papilloma virus status
Ingvild Ramberg, Peter Bjerre Toft, Jeanette B?hr Georgsen, Volkert Dirk Siersma, Mikkel Funding, David Hebbelstrup Jensen, Christian von Buchwald, Steffen Heegaard
doi : 10.1136/bjophthalmol-2019-315011
Aims Human papillomavirus (HPV) is considered a causative agent for the development of a broad range of human carcinomas. The role of HPV in the development of conjunctival intraepithelial neoplasia (CIN) and carcinoma (cSCC) remains unclear. The purpose of the present study was to investigate the HPV prevalence in a nationwide cohort and to describe clinical and histopathological features in relation to HPV status.
The effect of human platelet lysate on corneal nerve regeneration
Chin-Te Huang, Hsiao-Sang Chu, Kuo-Chi Hung, Lily Wei Chen, Mei-Yun Chen, Fung-Rong Hu, Wei-Li Chen
doi : 10.1136/bjophthalmol-2019-314408
Aim This study aimed to test whether human platelet lysate (HPL) has neurotrophic ability for corneal nerve regeneration.
