Journal Contents

Am Jour Ophthalmol
Br J Ophthalmol
Can J Ophthalmol
J Cat Ref Surg
Curr Eye Res
Eur J Ophthalmol
J Glaucoma
JAMA Ophthalmol
Graefes Ophthalmol
Indian J Ophthalmol
Int Ophthalmol Clin
Invest Ophth Vis Sci
Jpn J Ophthalmol
Korean J Ophthal
J Neuroophthalmol
Ophthalmic Epidemiol
Ophthalmic Genet
Ophthal Plast Rec Surg
Ophthalmic Res
Surv Ophthalmol
Ophthalmology Review Journal
Eye[JOUR] Established 1995
1. Eye (Lond). 2015 Mar 13. doi: 10.1038/eye.2015.26. [Epub ahead of print]

Evaluation of corneal endothelial cell damage after vitreoretinal surgery:
comparison of different endotamponades.

Cinar E(1), Zengin MO(1), Kucukerdonmez C(1).

Author information: 
(1)Department of Ophthalmology, Faculty of Medicine, Izmir University, Izmir,

PurposeWe evaluated corneal endothelial cell (EC) damage after vitreoretinal
surgery and compared the results using different tamponades.Materials and
methodsThis prospective controlled study included 45 eyes of 45 patients (24
females, 21 males) who underwent pars plana vitrectomy with gas (sulphur
hexafluoride, SF6, 20%) or silicone oil (SO) tamponade. Patients were assigned to
one of the three groups: group 1 (phakic, 20% SF6 gas), group 2 (pseudophakic,
20% SF6 gas), and group 3 (phakic, SO). Mean endothelial cell density (MCD), mean
cell area (MCA), coefficient of variation in cell size (CV), and percentage of
hexagonal cells (HC) values were measured using a non-contact specular microscope
(SP-2000P; Topcon, Japan) at baseline and at 3 months after surgery. The fellow
eye of each patient was used as a control.ResultsGroup 2, which had the lowest
baseline MCD and MCA values, was found to be different than groups 1 and 3
(P=0.028 and 0.022, respectively). At 3 months postoperatively, all groups showed
significantly lower MCD, HC and CV values than at baseline (all P<0.05). The mean
changes in MCD at 3 months after surgery were 3.8±2.8% (mean±SD), 8.0±7.5%, and
4.6±5.4% in groups 1-3, respectively. The mean MCD changes in the fellow eyes
were 0.31±1.41% in group 1, -0.63±1.90% in group 2, and 0.14±0.52 in group 3 at 3
months postoperatively (P>0.05 for all).ConclusionsOur findings revealed that
corneal EC damage may occur after vitreoretinal surgery with gas or SO tamponade.
Eyes that had undergone previous cataract surgery were more vulnerable to EC loss
than phakic eyes, supporting the protective effect of an intact lens.Eye advance 
online publication, 13 March 2015; doi:10.1038/eye.2015.26.

PMID: 25771819   [PubMed - as supplied by publisher]

2. Eye (Lond). 2015 Mar 13. doi: 10.1038/eye.2015.30. [Epub ahead of print]

Endothelial cell loss and complication rates with combined Descemets stripping
endothelial keratoplasty and cataract surgery in a UK centre.

Jones SM(1), Fajgenbaum MA(1), Hollick EJ(1).

Author information: 
(1)Department of Ophthalmology, King's College Hospital NHS Foundation Trust,
London, UK.

PurposeTo report 6-month, 1- and 2-year endothelial cell loss (ECL), intra- and
postoperative complications in a large series of patients undergoing either
Descemets stripping endothelial keratoplasty (DSEK) or a combined
phacoemulsification and DSEK in a UK centre.Patients and methodsPatients
undergoing DSEK with or without concurrent cataract surgery were included in this
retrospective study. Surgeries were performed between January 2006 and May 2013. 
Main outcomes included intra- and postoperative complications and percentage
ECL.ResultsDSEK was performed in 226 eyes (210 patients). Of these, 141 eyes (126
patients) underwent DSEK alone and 85 eyes (84 patients) underwent DSEK combined 
with cataract surgery. Excluding complex anterior segment pathology the mean
percentage ECL at 6, 12 and 24 months was 40.5±13.4, 45.1±14.6 and 53.1±13.0 in
the DSEK group and 40.7±15.4, 42.6±15.3 and 49.6±16.5 in patients undergoing the 
combined procedure, respectively. There was no significant difference in
percentage ECL at 6 or 24 months between the two groups both in complex and
routine cases. Intraoperative complications occurred in four patients undergoing 
DSEK and three undergoing combined procedure. Postoperative complication rates
did not reach statistical significance between the groups.ConclusionMean ECL and 
complication rates were comparable at 6, 12 and 24 months in routine cases
undergoing concurrent DSEK with cataract surgery and those undergoing DSEK. These
data support the combined procedure in patients requiring both cataract surgery
and endothelial keratoplasty. Further collaboration to report endothelial cell
counts from other UK centres should be encouraged.Eye advance online publication,
13 March 2015; doi:10.1038/eye.2015.30.

PMID: 25771818   [PubMed - as supplied by publisher]

3. Eye (Lond). 2015 Mar 13. doi: 10.1038/eye.2015.25. [Epub ahead of print]

Clinical relevance of quantified fundus autofluorescence in diabetic macular

Yoshitake S(1), Murakami T(1), Uji A(1), Unoki N(1), Dodo Y(1), Horii T(1),
Yoshimura N(1).

Author information: 
(1)Department of Ophthalmology and Visual Sciences, Kyoto University Graduate
School of Medicine, Kyoto, Japan.

PurposeTo quantify the signal intensity of fundus autofluorescence (FAF) and
evaluate its association with visual function and optical coherence tomography
(OCT) findings in diabetic macular oedema (DMO).MethodsWe reviewed 103 eyes of 78
patients with DMO and 30 eyes of 22 patients without DMO. FAF images were
acquired using Heidelberg Retina Angiograph 2, and the signal levels of FAF in
the individual subfields of the Early Treatment Diabetic Retinopathy Study grid
were measured. We evaluated the association between quantified FAF and the logMAR
VA and OCT findings.ResultsOne hundred and three eyes with DMO had lower FAF
signal intensity levels in the parafoveal subfields compared with 30 eyes without
DMO. The autofluorescence intensity in the parafoveal subfields was associated
negatively with logMAR VA and the retinal thickness in the corresponding
subfields. The autofluorescence levels in the parafoveal subfield, except the
nasal subfield, were lower in eyes with autofluorescent cystoid spaces in the
corresponding subfield than in those without autofluorescent cystoid spaces. The 
autofluorescence level in the central subfield was related to foveal cystoid
spaces but not logMAR VA or retinal thickness in the corresponding
area.ConclusionsQuantified FAF in the parafovea has diagnostic significance and
is clinically relevant in DMO.Eye advance online publication, 13 March 2015;

PMID: 25771817   [PubMed - as supplied by publisher]

4. Eye (Lond). 2015 Mar 13. doi: 10.1038/eye.2015.24. [Epub ahead of print]

Bimodal in vivo imaging provides early assessment of stem-cell-based
photoreceptor engraftment.

Laver CR(1), Metcalfe AL(1), Szczygiel L(2), Yanai A(1), Sarunic MV(3),
Gregory-Evans K(1).

Author information: 
(1)Department of Ophthalmology and Visual Sciences, Faculty of Medicine,
University of British Columbia, Vancouver, BC, Canada. (2)Department of Molecular
Biology and Biochemistry, Faculty of Science, Simon Fraser University, Burnaby,
BC, Canada. (3)School of Engineering Science, Faculty of Applied Science, Simon
Fraser University, Burnaby, BC, Canada.

PurposeSubretinal transplantation of stem-cell-derived photoreceptor precursor
cells (PPCs) is a promising and innovative approach to treating a range of
blinding diseases. However, common barriers to efficient preclinical
transplantation comes in the form of suboptimal graft architecture, limited graft
survival, and immune-rejection, each of which cannot be assessed using
conventional in vivo imaging (ie, rodent ophthalmoscopy). With the majority of
PPCs reported to die within the first few weeks after transplantation,
understanding the mechanisms of graft failure, and ultimately devising
preventative methods, currently relies on lengthy end point histology. To address
these limitations, we hypothesized that combining two imaging modalities, optical
coherence tomography (OCT) and fluorescence confocal scanning laser
ophthalmoscopy (fcSLO), could provide a more rapid and comprehensive view of PPC 
engraftment.MethodsHuman ESC-derived PPCs were transplanted into 15 retinal
dystrophic rats that underwent bimodal imaging at 0, 8, and 15 days
posttransplant.ResultsBimodal imaging provided serial detection of graft:
placement, architecture, and survival; each undetectable under ophthalmoscopy.
Bimodal imaging determined graft placement to be either: subretinal (n=7),
choroidal (n=4), or vitreal (n=4) indicating neural retinal perforation. Graft
architecture was highly variable at the time of transplantation, with notable
redistribution over time, while complete, or near complete, graft loss was
observed in the majority of recipients after day 8. Of particular importance was 
detection of vitreal aggregates overlying the graft-possibly an indicator of
host-site inflammation and rejection.ConclusionEarly real-time feedback of
engraftment has the potential to greatly increase efficiency of preclinical
trials in cell-based retinal therapeutics.Eye advance online publication, 13
March 2015; doi:10.1038/eye.2015.24.

PMID: 25771816   [PubMed - as supplied by publisher]

5. Eye (Lond). 2015 Mar 13. doi: 10.1038/eye.2015.32. [Epub ahead of print]

Gene-gene interaction of CFH, ARMS2, and ARMS2/HTRA1 on the risk of neovascular
age-related macular degeneration and polypoidal choroidal vasculopathy in Chinese

Huang L(1), Meng Q(1), Zhang C(2), Sun Y(1), Bai Y(1), Li S(1), Deng X(1), Wang
B(1), Yu W(1), Zhao M(1), Li X(1).

Author information: 
(1)1] Department of Ophthalmology, Peking University People's Hospital, Beijing, 
China [2] Key Laboratory of Vision Loss and Restoration, Ministry of Education,
Beijing, China [3] Department of Abdominal Surgical Oncology, Cancer Institute
and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 
Beijing, China. (2)Department of Clinical Epidemiology, Peking University
People's Hospital, Beijing, China.

PurposeTo evaluate the association and interaction of five single-nucleotide
polymorphisms (SNPs) in three genes (CFH, ARMS2, and ARMS2/HTRA1) with
neovascular age-related macular degeneration (nAMD) and polypoidal choroidal
vasculopathy (PCV) in Chinese population.MethodsA total of 300 nAMD and 300 PCV
patients and 301 normal subjects participated in the present study. The allelic
variants of rs800292, rs2274700, rs3750847, rs3793917, and rs1065489 were
determined by matrix-assisted laser desorption/ionization time-of-flight mass
spectrometry (MALDI-TOF-MS). Gene-gene interactions were evaluated by the data
mining approach multifactor-dimensionality reduction (MDR) method.ResultsThe risk
alleles of CFH rs800292, rs2274700, ARMS2 rs3057847, and ARMS2/HTRA1 rs3793917
showed significant difference between nAMD or PCV patients and controls (all
P<0.01). The homozygosity of risk alleles for rs800292, rs2274700, rs3750847, and
rs3793917 were significantly different between nAMD patients and controls (all
P<0.01), and predisposed to PCV patients (all P<0.01). After cross-validation
consistency (CVC) and permutation tests, the two-locus model rs2274700_rs3750847 
has a balanced accuracy of 64.37% in predicting nAMD disease risk. The one-marker
model, rs3750847, and two-locus model rs2274700_rs3750847 has a balanced accuracy
of 66.07% and 65.89% in predicting PCV disease risk, respectively. Furthermore,
CFH rs1065489 did not show significant association with nAMD (P>0.01), but was
strongly associated with PCV in Chinese patients (P<0.001).ConclusionsIn this
study, we found that the interaction of ARMS2 and ARMS2/HTRA1 is significantly
associated with nAMD, and the interaction of CFH and ARMS2 is pronounced in PCV
development in Chinese population.Eye advance online publication, 13 March 2015; 

PMID: 25771815   [PubMed - as supplied by publisher]

6. Eye (Lond). 2015 Mar 13. doi: 10.1038/eye.2015.21. [Epub ahead of print]

Failure of intravitreal bevacizumab in the treatment of choroidal metastasis.

Maudgil A(1), Sears KS(1), Rundle PA(1), Rennie IG(1), Salvi SM(1).

Author information: 
(1)Sheffield Ocular Oncology Service, Department of Ophthalmology, Royal
Hallamshire Hospital, Sheffield, UK.

BackgroundMetastasis to choroid is the most common intraocular malignancy,
arising most frequently from carcinoma of breast in women and lung in men. Recent
case reports have described successful use of intravitreal bevacizumab to achieve
local control of such tumours.Materials and methodsFive cases of choroidal
metastases from varying primaries: breast, lung, and colon were treated with
intravitreal bevacizumab, and tumour response observed and documented with serial
photographs and B-scans.ResultsFour of the five tumours were seen to progress
despite intravitreal bevacizumab treatment.ConclusionsIntravitreal bevacizumab as
the primary treatment of choroidal metastases is not recommended and should not
delay more effective alternative treatments.Eye advance online publication, 13
March 2015; doi:10.1038/eye.2015.21.

PMID: 25771814   [PubMed - as supplied by publisher]

7. Eye (Lond). 2015 Mar;29(3):452. doi: 10.1038/eye.2015.4.

Choroid thickness and ocular pulse amplitude in migraine during attack.

Dervisogullari MS, Totan Y, Gençler OS.

PMID: 25762130   [PubMed - in process]

8. Eye (Lond). 2015 Mar;29(3):450-1. doi: 10.1038/eye.2014.321.

Two-year outcome of an observe-and-plan regimen for neovascular age-related
macular degeneration: how to alleviate the clinical burden with maintained
functional results.

Gianniou C, Dirani A, Ferrini W, Marchionno L, Decugis D, Deli A, Ambresin A,
Mantel I.

PMID: 25762129   [PubMed - in process]

9. Eye (Lond). 2015 Mar 6. doi: 10.1038/eye.2014.311. [Epub ahead of print]

Myopic foveoschisis: a clinical review.

Gohil R(1), Sivaprasad S(2), Han LT(3), Mathew R(4), Kiousis G(4), Yang Y(5).

Author information: 
(1)NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS
Foundation Trust, London, UK. (2)1] NIHR Biomedical Research Centre for
Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK [2] Laser
and Retinal Research Unit, Department of Ophthalmology, King's College Hospital, 
London, UK. (3)National Healthcare Group Eye Institute, Tan Tock Seng Hospital,
Singapore, Singapore. (4)Laser and Retinal Research Unit, Department of
Ophthalmology, King's College Hospital, London, UK. (5)Faculty of Life and Health
Sciences, Aston University, Birmingham, UK.

To review the literature on epidemiology, clinical features, diagnostic imaging, 
natural history, management, therapeutic approaches, and prognosis of myopic
foveoschisis. A systematic Pubmed search was conducted using search terms:
myopia, myopic, staphyloma, foveoschisis, and myopic foveoschisis. The evidence
base for each section was organised and reviewed. Where possible an authors'
interpretation or conclusion is provided for each section. The term myopic
foveoschisis was first coined in 1999. It is associated with posterior staphyloma
in high myopia, and is often asymptomatic initially but progresses slowly,
leading to loss of central vision from foveal detachment or macular hole
formation. Optical coherence tomography is used to diagnose the splitting of the 
neural retina into a thicker inner layer and a thinner outer layer, but compound 
variants of the splits have been identified. Vitrectomy with an internal limiting
membrane peel and gas tamponade is the preferred approach for eyes with vision
decline. There has been a surge of new information on myopic foveoschisis.
Advances in optical coherence tomography will continually improve our
understanding of the pathogenesis of retinal splitting, and the mechanisms that
lead to macular damage and visual loss. Currently, there is a good level of
consensus that surgical intervention should be considered when there is
progressive visual decline from myopic foveoschisis.Eye advance online
publication, 6 March 2015; doi:10.1038/eye.2014.311.

PMID: 25744445   [PubMed - as supplied by publisher]

10. Eye (Lond). 2015 Mar 6. doi: 10.1038/eye.2015.2. [Epub ahead of print]

Retinal artery lesions and long-term outcome in Chinese patients with acute
coronary syndrome.

Wang J(1), Zhao M(2), Li SJ(1), Wang DZ(2).

Author information: 
(1)Department of Cardiology, Beijing Mentougou District Hospital, Beijing, China.
(2)Department of Cardiology, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China.

ObjectiveTo investigate the relationship between staging of retinal artery
lesions and the prognosis of acute coronary syndrome (ACS) in a Chinese
population.MethodsA total of 436 Chinese patients with ACS underwent coronary
angiography and the eyes fundus examinations. All the patients were divided into 
three groups: group 1, no retinal artery lesions (n=111); group 2, retinal artery
lesions of PMID: 25744444   [PubMed - as supplied by publisher]

11. Eye (Lond). 2015 Mar 6. doi: 10.1038/eye.2015.18. [Epub ahead of print]

Botulinum toxin injection for the treatment of epiphora in lacrimal outflow

Ziahosseini K(1), Al-Abbadi Z(1), Malhotra R(1).

Author information: 
(1)Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, West Sussex,

Purpose:To describe our experience with the use of botulinum toxin (BoNTA) for
the symptomatic treatment of lacrimal outflow obstruction.Methods:We
retrospectively reviewed the case notes of patients with epiphora due to lacrimal
outflow obstruction who chose to have injections of botulinum toxin into the
palpebral lobe of the lacrimal gland instead of surgery between 2009 and 2014.
Epiphora was graded subjectively with Munk scores obtained before and after
treatment as well as qualitative degree of improvement reported by the patients. 
Severity and duration of side effects were also noted.Results:Seventeen patients 
(22 eyes, mean age 70.3, 4 males and 13 females) were identified. A mean of 3.5
(range; 1-10) injections of BoNTA (Botox, Allergan; 1.25-7.5 units) were given
per eye. The mean interval between injections was 3.9 months (range 3-6). The
mean Munk score (3.4, range 2-4) improved significantly after treatment to 1.6
(range: 0-3, P=0.0001 paired two-tailed t-test). Epiphora completely resolved in 
a fifth, improved by up to 60-90% in a half and only 'a little better' in a
further fifth. Temporary bruising and diplopia (lasting 2 weeks) was reported in 
12% (2/17).Conclusion:We report our outcomes for BoNTA to the palpebral lobe of
the lacrimal gland in patients with lacrimal outflow obstruction epiphora seeking
alternatives to surgery. This data provide further evidence for informed consent 
and for commissioning organisations considering the funding of this treatment.Eye
advance online publication, 6 March 2015; doi:10.1038/eye.2015.18.

PMID: 25744443   [PubMed - as supplied by publisher]

12. Eye (Lond). 2015 Mar 6. doi: 10.1038/eye.2015.12. [Epub ahead of print]

Implantation of refractive multifocal intraocular lens with a surface-embedded
near section for cataract eyes complicated with a coexisting ocular pathology.

Ouchi M(1), Kinoshita S(2).

Author information: 
(1)1] Ouchi Eye Clinic, Kyoto, Japan [2] Department of Ophthalmology, Kyoto
Prefectural University of Medicine, Kyoto, Japan. (2)Department of Ophthalmology,
Kyoto Prefectural University of Medicine, Kyoto, Japan.

PurposeTo evaluate the postoperative outcomes of cataract eyes complicated with
coexisting ocular pathologies that underwent implantation of a refractive
multifocal intraocular lens (MIOL) with a surface-embedded near
section.MethodsLENTIS MPlus (Oculentis GmbH) refractive MIOLs were implanted in
15 eyes with ocular pathologies other than cataract (ie, six high-myopia eyes
with an axial length longer than 28 mm, two fundus albipunctatus eyes, two branch
retinal-vein occlusion eyes, four glaucoma eyes (one with high myopia), and two
keratoconus eyes). Uncorrected or corrected distance and near visual acuity (VA) 
(UDVA, UNVA, CDVA, and CNVA), contrast sensitivity, and defocus curve were
measured at 1 day and 6 months postoperatively, and each patient completed a
6-month postoperative questionnaire regarding vision quality and eyeglass
use.ResultsThirteen eyes (87%) registered 0 or better in CDVA and 12 eyes (73%)
registered better than 0 in CNVA. Contrast sensitivity in the eyes of all
patients was comparable to that of normal healthy subjects. No patient required
eyeglasses for distance vision, but three patients (20%) required them for near
vision. No patient reported poor or very poor vision quality.ConclusionWith
careful case selection, sectorial refractive MIOL implantation is effective for
treating cataract eyes complicated with ocular pathologies.Eye advance online
publication, 6 March 2015; doi:10.1038/eye.2015.12.

PMID: 25744442   [PubMed - as supplied by publisher]

13. Eye (Lond). 2015 Mar 6. doi: 10.1038/eye.2015.27. [Epub ahead of print]

En face OCT angiography demonstrates flow in early type 3 neovascularization
(retinal angiomatous proliferation).

Dansingani KK(1), Naysan J(2), Freund KB(2).

Author information: 
(1)1] Vitreous Retina Macula Consultants of New York, New York, NY, USA [2]
LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat
Hospital, New York, NY, USA [3] Moorfields Eye Hospital, London, UK. (2)1]
Vitreous Retina Macula Consultants of New York, New York, NY, USA [2] LuEsther T.
Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, 
NY, USA [3] Department of Ophthalmology, New York University School of Medicine, 
New York, NY, USA.

IntroductionThe characteristics of type 3 neovascularization (NV), also known as 
retinal angiomatous proliferation, have been well described clinically, as well
as with fluorescein angiography (FA), indocyanine green angiography, and optical 
coherence tomography (OCT). OCT angiography (OCT-A) is a novel and non-invasive
technique for imaging retinal microvasculature by detecting changes, with respect
to time, in reflectivity related to blood flow.MethodIn this case series, we
describe two patients who presented with type 3 NV and underwent clinical
examination and multimodal imaging, including OCT-A.ResultsIn the first patient, 
OCT-A demonstrated flow within two separate lesions in the same eye, one of which
was only weakly detected by FA. In the second patient, sequential OCT-A
demonstrated a reduction in intralesional flow following intravitreal
therapy.ConclusionsOCT-A may have a role in the early diagnosis of type 3 NV and 
in assessing the response to treatment. Further studies are needed to determine
sensitivity and specificity.Eye advance online publication, 6 March 2015;

PMID: 25744441   [PubMed - as supplied by publisher]