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 Jul 24. doi: 10.1038/eye.2015.132. [Epub ahead of print]

Design characteristic of randomised controlled trials for geographic atrophy in
age-related macular degeneration: selection of outcomes and sample size

Krezel AK(1), Hogg RE(1), Krezel S(2), Fallis R(3), Azuara-Blanco A(1).

Author information: 
(1)Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK.
(2)Former student of Queen's University Belfast, Belfast, UK. (3)Medical Library,
Queen's University Belfast, Belfast, UK.

PurposeThe selection of suitable outcomes and sample size calculation are
critical factors in the design of a randomised controlled trial (RCT). The goal
of this study was to identify the range of outcomes and information on sample
size calculation in RCTs on geographic atrophy (GA).MethodsWe carried out a
systematic review of age-related macular degeneration (AMD) RCTs. We searched
MEDLINE, EMBASE, Scopus, Cochrane Library,, and Two independent reviewers screened records. One reviewer 
collected data and the second reviewer appraised 10% of collected data. We
scanned references lists of selected papers to include other relevant
RCTs.ResultsLiterature and registry search identified 3816 abstracts of journal
articles and 493 records from trial registries. From a total of 177 RCTs on all
types of AMD, 23 RCTs on GA were included. Eighty-one clinical outcomes were
identified. Visual acuity (VA) was the most frequently used outcome, presented in
18 out of 23 RCTs and followed by the measures of lesion area. For sample size
analysis, 8 GA RCTs were included. None of them provided sufficient Information
on sample size calculations.ConclusionsThis systematic review illustrates a lack 
of standardisation in terms of outcome reporting in GA trials and issues
regarding sample size calculation. These limitations significantly hamper
attempts to compare outcomes across studies and also perform meta-analyses.Eye
advance online publication, 24 July 2015; doi:10.1038/eye.2015.132.

PMID: 26206532   [PubMed - as supplied by publisher]

2. Eye (Lond). 2015 Jul 24. doi: 10.1038/eye.2015.138. [Epub ahead of print]

Effectiveness of a smartphone application for testing near visual acuity.

Tofigh S(1), Shortridge E(1), Elkeeb A(1), Godley BF(1).

Author information: 
(1)Department of Ophthalmology and Visual Sciences, University of Texas Medical
Branch, Galveston, TX, USA.

PurposeThe purpose of this study was to evaluate the discrepancy between the near
visual acuity (VA) measurements using the EyeHandBook smartphone application and 
the conventional method of using the near vision card.MethodsUsing similar
environmental/examinational conditions, near VA measurements were obtained and
compared using the near vision card and the EyeHandBook app for IPhone 5 from 100
subjects. The obtained data were changed to LogMAR format and the relationship
between the two techniques was analyzed by paired sample t-test and
scatterplot.ResultsWith a P-value of<0.0001, our results indicate that the
EyeHandBook application running on IPhone 5 overestimates the near VA compared
with the conventional near vision card by an average of 0.11 LogMAR unless the
measurement done by the near vision card was 20/20.ConclusionsOwing to vast
utilization of portable high-definition screens in VA measurements, eye-care
providers have to be mindful of the potential disparity in VA measurement between
different platforms, which in our study was likely secondary to the high contrast
and brightness levels of the smartphone's high-definition screen when compared
with the near vision card.Eye advance online publication, 24 July 2015;

PMID: 26206531   [PubMed - as supplied by publisher]

3. Eye (Lond). 2015 Jul 24. doi: 10.1038/eye.2015.128. [Epub ahead of print]

Evaluating the impact of summer vacation on the visual acuity of AMD patients
treated with ranibizumab.

Massamba N(1), Dirani A(2), Knoeri J(1), Pasquier B(1), Ingram A(3), Soubrane

Author information: 
(1)Department of Ophthalmology, Cergy Pontoise Hospital, Paris, France.
(2)Department of Ophthalmology, CHUV, Lausanne, Switzerland. (3)Department of
Ophthalmology, April Ingram Research Consultants, Kelowna, British Columbia,
Canada. (4)Department of Ophthalmology, Hotel Dieu Hospital, Paris V University, 
Paris, France.

PurposeTo evaluate the impact of traditional French summer vacation on visual
acuity and spectral domain-optical coherence tomography (SD-OCT) of Wet AMD
patients being treated with intravitreal Ranibizumab.MethodsThis was a
consecutive, comparative, single-centre, prospective analysis. All patients who
were being treated with intravitreal injection of 0.5 mg ranibizumab at Cergy
Pontoise Hospital, Department of Ophthalmology between July 2013 and September
2014 were included. Patients were divided into two groups: (A) patients who
skipped one ranibizumab intravitreal injection during holidays, and (B) patients 
who received injection during their holidays. Evaluations occurred prior to
traditional holiday (baseline) and 2 months later, consisting of BCVA using
ETDRS, and a complete ophthalmic examination that included slit-lamp
biomicroscopy, fundus examination, fluorescein angiography (FA), indocyanine
green angiography (ICGA), and spectral domain-optical coherence tomography
(SD-OCT). All patients were being treated with PRN anti-VEGF regimen and criteria
for reinjection included a visual acuity loss >5 ETDRS letters and/or an increase
of central retinal thickness, presence of subretinal fluid, intraretinal fluid,
or pigment epithelium detachment. If reinjection criteria were not met, patients 
were advised to return in 4 weeks.ResultsThe mean visual acuity change was
-0.071±0.149 (LogMAR) in group A and +0.003±0.178 in group B (P=0.041). At the
second visit (2 months after preholidays visit), 61.8% of patients in group A had
SRF and/or intraretinal cysts, and only 27.6% of patients in group B. There was a
significant difference in the persistence of fluid between the two groups
(P=0.007, χ(2)-test).ConclusionThis cases series demonstrated the detrimental
impact of holidays on visual acuity in patients treated with ranibizumab for AMD,
which, in spite of their treatment regimen, still leave in vacation. Therefore,
it is important to convey the message of treatment adherence to patients, despite
their need of holidays.Eye advance online publication, 24 July 2015;

PMID: 26206530   [PubMed - as supplied by publisher]

4. Eye (Lond). 2015 Jul 24. doi: 10.1038/eye.2015.124. [Epub ahead of print]

The genetic mechanisms of primary angle closure glaucoma.

Ahram DF(1), Alward WL(1), Kuehn MH(1).

Author information: 
(1)Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa 
City, IA, USA.

Primary Angle Closure Glaucoma (PACG) is one of the most common types of glaucoma
affecting over 15 million individuals worldwide. Family history and ethnicity are
strongly associated with the development of the disease, suggesting that one or
more genetic factors contribute to PACG. Although strictly heritable
disease-causing mutations have not been identified, a number of recent
association studies have pointed out genetic factors that appear to contribute to
an individual's risk to develop PACG. In addition, genetic factors have been
identified that modify PACG endophenotypes for example, axial length. Herein we
review the current literature on this important topic.Eye advance online
publication, 24 July 2015; doi:10.1038/eye.2015.124.

PMID: 26206529   [PubMed - as supplied by publisher]

5. Eye (Lond). 2015 Jul 24. doi: 10.1038/eye.2015.129. [Epub ahead of print]

Effect of laser suture lysis on filtration openings: a prospective
three-dimensional anterior segment optical coherence tomography study.

Cho HK(1), Kojima S(2), Inoue T(2), Fukushima A(2), Kee C(3), Tanihara H(2).

Author information: 
(1)1] Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University,
Kumamoto, Japan [2] Department of Ophthalmology, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
(2)Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University,
Kumamoto, Japan. (3)Department of Ophthalmology, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

PurposeTo investigate the effects of laser suture lysis (LSL) on filtration
openings after trabeculectomy.MethodsProspective study analyzing the changes in
the location and width of filtration openings, fluid cavity height, total bleb
height, bleb wall thickness, and bleb wall intensity before and after LSL using
three-dimensional anterior segment optical coherence tomography (3D
AS-OCT).ResultsFourteen patients had clear scleral flap image analysis. As five
patients underwent LSL twice and two patients underwent LSL thrice, 23 comparison
studies were possible. After LSL the intraocular pressure (IOP) decreased
(P=0.0015) from 20.5±5.3 to 14.9±6.4 mm Hg, and the fluid cavity height increased
significantly from 0.2±0.2 mm to 0.3±0.1 mm (P=0.0094). Other bleb parameters
were not significantly different when comparing before and after LSL. When the
IOP reduction ratio was >25% following LSL, the width of the filtration openings 
on the LSL side, the total bleb height, and the fluid cavity height increased
(P=0.0273, 0.0342, and 0.0024, respectively). In multiple regression analysis the
changes in fluid cavity height, the wall thickness, the wall intensity, and the
width of the filtration opening were positively associated with the IOP reduction
rate (P=0.0428, 0.0226, 0.0420, and 0.0356, respectively).Conclusions3D AS-OCT
allowed a detailed examination of the internal morphology of filtration blebs and
openings before and after LSL. The changes in the internal morphology were
closely associated with the success of LSL to decrease IOP.Eye advance online
publication, 24 July 2015; doi:10.1038/eye.2015.129.

PMID: 26206528   [PubMed - as supplied by publisher]

6. Eye (Lond). 2015 Jul 17. doi: 10.1038/eye.2015.133. [Epub ahead of print]

Comparison of photoreceptor outer segment length in diabetic and idiopathic
epiretinal membranes.

Yüksel K(1), Karaküçük Y(2), Özkaya A(1), Pekel G(3), Baz Ö(1), Alagöz C(1),
Yazıcı AT(1).

Author information: 
(1)Ophthalmology Department, Beyoglu Eye Training and Research Hospital, Eye
Clinic, Istanbul, Turkey. (2)Besni State Hospital, Eye Clinic, Adıyaman, Turkey. 
(3)Ophthalmology Department, Pamukkale University, Denizli, Turkey.

PurposeIdiopathic and diabetic epiretinal membranes (ERMs) differ significantly
in terms of macular morphology. Our aim was to compare the photoreceptor outer
segment (PROS) length in diabetic and idiopathic ERMs before and after
surgery.MethodsFifty-two eyes of 50 patients who underwent pars plana vitrectomy 
(PPV) due to idiopathic and diabetic ERMs were included in this retrospective
case series. All of the patients underwent ERM and internal limiting membrane
(ILM) removal. The patients had been followed up 6 months postoperatively.
Spectral-domain optical coherence tomography (OCT) was used to measure the PROS
length, overall PR length and central foveal thickness (CFT).ResultsThe PROS
length, overall PR length, and CFT were statistically significantly lower at all 
the postoperative visits when compared to preoperative values in both the
idiopathic and diabetic ERM groups (P<0.001). The amount of decrease in PROS and 
overall PR length were similar in both groups after surgery (P>0.05). There was
no relation between amount of PROS length change and visual acuity gain in both
groups (P>0.05).ConclusionsPostoperative change of PROS length was similar in
idiopathic and diabetic ERMs. PROS length change may not be an indicator of
postoperative visual acuity.Eye advance online publication, 17 July 2015;

PMID: 26183287   [PubMed - as supplied by publisher]

7. Eye (Lond). 2015 Jul 17. doi: 10.1038/eye.2015.127. [Epub ahead of print]

Literature review and meta-analysis of translaminar pressure difference in
open-angle glaucoma.

Siaudvytyte L(1), Januleviciene I(1), Daveckaite A(1), Ragauskas A(2), Bartusis
L(3), Kucinoviene J(1), Siesky B(4), Harris A(5).

Author information: 
(1)Eye Clinic, Lithuanian University of Health Sciences, Kaunas, Lithuania.
(2)Health Telematics Science Centre of Kaunas University of Technology, Kaunas,
Lithuania. (3)1] Eye Clinic, Lithuanian University of Health Sciences, Kaunas,
Lithuania [2] Health Telematics Science Centre of Kaunas University of
Technology, Kaunas, Lithuania. (4)Glaucoma Research and Diagnostic Center, Eugene
and Marilyn Glick Eye Institute, Indiana University School of Medicine,
Indianapolis, IN, USA. (5)1] Eye Clinic, Lithuanian University of Health
Sciences, Kaunas, Lithuania [2] Glaucoma Research and Diagnostic Center, Eugene
and Marilyn Glick Eye Institute, Indiana University School of Medicine,
Indianapolis, IN, USA.

There is increasing evidence in the literature regarding translaminar pressure
difference's (TPD) role in the pathophysiology of glaucoma. The optic nerve is
exposed not only to intraocular pressure in the eye, but also to intracranial
pressure (ICP), as it is surrounded by cerebrospinal fluid in the subarachnoid
space. Although pilot studies have identified the potential importance of TPD in 
glaucoma, limited available data currently prevent a comprehensive description of
the role that TPD may have in glaucomatous pathophysiology. In this review, we
present all available qualified data from a systematic review of the literature
of the role of TPD in open-angle glaucoma (OAG). PubMed (Medline), OVID Medline, 
ScienceDirect, SpringerLink, and all available library databases were reviewed
and subsequent meta-analysis of pooled mean differences are presented where
appropriate. Five papers including 396 patients met criteria for inclusion to the
analysis. Importantly, we included all observational studies despite differences 
in ICP measurement methods, as there is no consensus regarding best-practice ICP 
measurements in glaucoma. Our results show that not only TPD is higher in
glaucoma patients compared with healthy subjects, it is related to structural
glaucomatous changes of the optic disc. Our analysis suggests further
longitudinal prospective studies are needed to investigate the influence of TPD
in OAG, with a goal of overcoming methodological weaknesses of previous
studies.Eye advance online publication, 17 July 2015; doi:10.1038/eye.2015.127.

PMID: 26183286   [PubMed - as supplied by publisher]

8. Eye (Lond). 2015 Jul 17. doi: 10.1038/eye.2015.130. [Epub ahead of print]

Evaluating digital diabetic retinopathy screening in people aged 90 years and

Tye A(1), Wharton H(1), Wright A(1), Yang Y(2), Gibson J(3), Syed A(1), Mills
A(1), Dodson P(3).

Author information: 
(1)Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham,
UK. (2)1] School of Health and Life Sciences, Aston University, Birmingham, UK
[2] Birmingham and Midland Eye Centre, City Hospital, Birmingham, UK. (3)1]
Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK
[2] School of Health and Life Sciences, Aston University, Birmingham, UK.

PurposeTo evaluate the effectiveness of digital diabetic retinopathy screening in
patients aged 90 years and over.MethodsThis is a retrospective analysis of 200
randomly selected patients eligible for diabetic retinopathy screening aged 90
years and over within the Birmingham, Solihull, and Black Country Screening
Programme.ResultsOne hundred and seventy-nine (90%) patients attended screening
at least once.OUTCOMES: 133 (74%) annual screening after their first screen, of
whom 59% had no detectable diabetic retinopathy; 38 (21%) were referred for
ophthalmology clinical assessment-36 for nondiabetic retinopathy reasons and two 
for diabetic maculopathy. Cataract accounted for 50% of all referrals for
ophthalmology clinical assessment. Of the 133 patients placed on annual
screening, 93 (70%) were screened at least once more. In terms of level of
diabetic retinopathy, assessability or other ocular pathologies, 8 improved, 51
remained stable, and 31 deteriorated. Of the latter, 19 patients were referred
for ophthalmology clinical assessment; none of these for diabetic
retinopathy.ConclusionsScreening provides opportunistic identification of
important nondiabetic retinopathy eye conditions. However, in view of the low
identification rate of sight-threatening diabetic retinopathy in patients aged 90
years and over, and the current mission statement of the NHS Diabetic Eye
Screening Programme, systematic annual diabetic retinopathy screening may not be 
justified in this age group of patients, but rather be performed in optometric
practice.Eye advance online publication, 17 July 2015; doi:10.1038/eye.2015.130.

PMID: 26183285   [PubMed - as supplied by publisher]

9. Eye (Lond). 2015 Jul 17. doi: 10.1038/eye.2015.126. [Epub ahead of print]

Surgical outcomes of 25-gauge pars plana vitrectomy for diabetic tractional
retinal detachment.

Dikopf MS(1), Patel KH(1), Setlur VJ(1), Lim JI(1).

Author information: 
(1)Retina Service, UIC Department of Ophthalmology and Visual Sciences, Illinois 
Eye and Ear Infirmary, University of Illinois Hospital & Health Sciences System, 
Chicago, IL, USA.

PurposeTo evaluate the outcomes and complications of 25-gauge (G) pars plana
vitrectomy (PPV) for repair of diabetic tractional retinal detachment
(TRD).MethodsRetrospective review of consecutive, single-surgeon 25-G PPV cases
between July 2007 and July 2014. Seventy eyes from 55 patients were operated on
for diabetic TRD; all eyes were tamponaded with sulfur hexafluoride,
octofluoropropane, silicone oil, or balanced salt solution. Mean age at surgery
was 47.7 years (range 23-76 years), and mean length of follow-up was 713 days
(range 90-2368 days; median 671 days). Primary outcomes included best-corrected
visual acuity (BCVA), intraocular pressure (IOP), anatomic success, redetachment,
and endophthalmitis.ResultsPreoperatively, 49 eyes (70%) had a concurrent
rhegmatogenous component (8 of which also had proliferative vitreoretinopathy
(PVR)). Mean BCVA improved from logarithm of the minimal angle of resolution 1.59
(20/800, SD 0.88) to 0.68 postoperatively (20/100, 0.77), P-value<0.001. Mean IOP
increased from 15.9 to 20 mm Hg 1 day after surgery. Elevated postoperative IOP
(≥22 mm Hg) occurred in 25 eyes, and low IOP (≤5 mm Hg) occurred in 2 eyes.
Primary reattachment was achieved in 63 eyes (90%), and final anatomical success 
occurred in 69 eyes (99%). There were no cases of
endophthalmitis.ConclusionsTwenty-five-G PPV repair was safe and effective in the
repair of diabetic TRD, including eyes with a combined rhegmatogenous detachment 
or PVR. Gas, silicone oil, and balanced salt solution tamponading agents all
proved to be efficacious in this surgical population.Eye advance online
publication, 17 July 2015; doi:10.1038/eye.2015.126.

PMID: 26183284   [PubMed - as supplied by publisher]

10. Eye (Lond). 2015 Jul 17. doi: 10.1038/eye.2015.108. [Epub ahead of print]

Long-term effect of phacoemulsification on trabeculectomy function.

Longo A(1), Uva MG(1), Reibaldi A(1), Avitabile T(1), Reibaldi M(1).

Author information: 
(1)Eye Clinic, University of Catania, Catania, Italy.

PurposeTo investigate the long-term effect of phacoemulsification on intraocular 
pressure (IOP) in trabeculectomized eyes and to identify the factors affecting
the IOP changes.MethodsIn consecutive patients with previous trabeculectomy (TE) 
who underwent uncomplicated clear cornea phacoemulsification we evaluated
intraocular pressure, need of antiglaucomatous medical therapy or glaucoma
surgery, and length of glaucoma control without therapy. Glaucoma therapy was
prescribed in the presence of IOP >18 mm Hg or worsening of the visual field. A
group of trabeculectomized eyes that did not receive cataract surgery was
retrospectively selected as a control. Multivariate analysis was used to test
factors related to final outcome of the treatment.ResultsOne hundred and eight
eyes with previous TE that received phacoemulsification and 108 controls were
included in the study. Phacoemulsification was performed 60±21 months after TE.
After a mean follow-up of 66±28 months, mean IOP was significantly increased in
the cataract surgery group (by 1.7±4.3 mm Hg) and in the control group (by
2.3±4.3 mm Hg)(both P<0.001); in two groups, respectively, 31 eyes (28.7%) and 17
eyes (15.7%) had received glaucoma therapy (chi-square P=0.030). Factors related 
to success (no need of therapy) were use of mitomycin-C (MMC) in previous TE
(P<0.001), longer time from TE to cataract surgery (P=0.007), higher preoperative
bleb score (P=0.021), and lower baseline IOP (P=0.042).ConclusionsCataract
surgery reduces the function of filtering bleb in some eyes. Factors related to
low rate of failure are the previous use of MMC during TE, longer time from TE to
cataract surgery, and good preoperative aspect of the bleb.Eye advance online
publication, 17 July 2015; doi:10.1038/eye.2015.108.

PMID: 26183283   [PubMed - as supplied by publisher]

11. Eye (Lond). 2015 Jul 10. doi: 10.1038/eye.2015.123. [Epub ahead of print]

Response to 'Role of miotics and cycloplegics in angle closure'.

Rajamani M(1), Kawali A(1), Vijayalakshmi P(1), Puthuran GV(1).

Author information: 
(1)Department of Pediatric Ophthalmology, Aravind Eye Hospital, Madurai, India.

PMID: 26160533   [PubMed - as supplied by publisher]

12. Eye (Lond). 2015 Jul 10. doi: 10.1038/eye.2015.118. [Epub ahead of print]

Pattern recognition receptors in microbial keratitis.

Taube MA(1), Del Mar Cendra M(2), Elsahn A(1), Christodoulides M(2), Hossain

Author information: 
(1)1] Division of Clinical and Experimental Sciences, Faculty of Medicine,
University of Southampton, Southampton, UK [2] University Hospital Southampton
NHS Foundation Trust, Southampton, UK. (2)Division of Clinical and Experimental
Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.

Microbial keratitis is a significant cause of global visual impairment and
blindness. Corneal infection can be caused by a wide variety of pathogens, each
of which exhibits a range of mechanisms by which the immune system is activated. 
The complexity of the immune response to corneal infection is only now beginning 
to be elucidated. Crucial to the cornea's defences are the pattern-recognition
receptors: Toll-like and Nod-like receptors and the subsequent activation of
inflammatory pathways. These inflammatory pathways include the inflammasome and
can lead to significant tissue destruction and corneal damage, with the potential
for resultant blindness. Understanding the immune mechanisms behind this tissue
destruction may enable improved identification of therapeutic targets to aid
development of more specific therapies for reducing corneal damage in infectious 
keratitis. This review summarises current knowledge of pattern-recognition
receptors and their downstream pathways in response to the major
keratitis-causing organisms and alludes to potential therapeutic approaches that 
could alleviate corneal blindness.Eye advance online publication, 10 July 2015;

PMID: 26160532   [PubMed - as supplied by publisher]

13. Eye (Lond). 2015 Jul 10. doi: 10.1038/eye.2015.109. [Epub ahead of print]

Outcomes of treatment with stereotactic radiosurgery or proton beam therapy for
choroidal melanoma.

Sikuade MJ(1), Salvi S(1), Rundle PA(1), Errington DG(2), Kacperek A(2), Rennie

Author information: 
(1)Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield, UK. 
(2)Department of Oncology, Douglas Cyclotron, Clatterbridge Cancer Centre,
Wirral, UK.

AimTo present our experience of the use of stereotactic radiosurgery and proton
beam therapy to treat posterior uveal melanoma over a 10 year period.Methods and 
materialsCase notes of patients treated with stereotactic radiosurgery (SRS), or 
Proton beam therapy (PBT) for posterior uveal melanoma were reviewed. Data
collected included visual acuity at presentation and final review, local control 
rates, globe retention and complications. We analysed post-operative visual
outcomes and if visual outcomes varied with proximity to the optic nerve or
fovea.Results191 patients were included in the study; 85 and 106 patients
received Stereotactic radiosurgery and Proton beam therapy, respectively. Mean
follow up period was 39 months in the SRS group and 34 months in the PBT group.
Both treatments achieved excellent local control rates with eye retention in 98% 
of the SRS group and 95% in the PBT group. The stereotactic radiosurgery group
showed a poorer visual prognosis with 65% losing more than 3 lines of Snellen
acuity compared to 45% in the PBT group. 33% of the SRS group and 54% of proton
beam patients had a visual acuity of 6/60 or better.ConclusionsStereotactic
radiosurgery and proton beam therapy are effective treatments for larger
choroidal melanomas or tumours unsuitable for plaque radiotherapy. Our results
suggest that patients treated with proton beam therapy retain better vision
post-operatively; however, possible confounding factors include age, tumour
location and systemic co-morbidities. These factors as well as the patient's
preference should be considered when deciding between these two therapies.Eye
advance online publication, 10 July 2015; doi:10.1038/eye.2015.109.

PMID: 26160531   [PubMed - as supplied by publisher]

14. Eye (Lond). 2015 Jul 10. doi: 10.1038/eye.2015.122. [Epub ahead of print]

Role of miotics and cycloplegics in angle closure.

Gupta D(1).

Author information: 
(1)Norfolk and Norwich University Hospital, Norwich, UK.

PMID: 26160530   [PubMed - as supplied by publisher]

15. Eye (Lond). 2015 Jul 10. doi: 10.1038/eye.2015.120. [Epub ahead of print]

Dementia is associated with open-angle glaucoma: a population-based study.

Chung SD(1), Ho JD(2), Chen CH(3), Lin HC(4), Tsai MC(5), Sheu JJ(6).

Author information: 
(1)1] Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei,
Taiwan [2] Sleep Research Center, Taipei Medical University Hospital, Taipei,
Taiwan. (2)Department of Ophthalmology, Taipei Medical University Hospital,
Taipei, Taiwan. (3)1] Department of Thoracic Surgery, Mackay Memorial Hospital,
Taipei, Taiwan [2] Mackay Medicine, Nursing, and Management College, Taipei,
Taiwan. (4)1] Sleep Research Center, Taipei Medical University Hospital, Taipei, 
Taiwan [2] School of Health Care Administration, Taipei Medical University,
Taipei, Taiwan. (5)1] School of Health Care Administration, Taipei Medical
University, Taipei, Taiwan [2] Department of Internal Medicine, Cathay General
Hospital, Taipei, Taiwan. (6)1] Department of Neurology, Taipei Medical
University Hospital, Taipei, Taiwan [2] Department of Neurology, School of
Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

PurposePrevious epidemiologic studies that focused on the association between
open-angle glaucoma (OAG) and dementia showed inconsistent results. In the
present study, we explored the association between OAG and dementia in an ethnic 
Chinese (ie, Taiwanese) population using a population-based data set.MethodsWe
retrieved data on study subjects for this case-control study from the
Longitudinal Health Insurance Database 2000. We identified 7770 patients who had 
a diagnosis of dementia as cases, and 7770 subjects matched in terms of sex and
age, which were randomly extracted as controls. A conditional logistic regression
conditioned on age group, sex, and index year was used to assess the association 
of dementia with previously diagnosed OAG among the sampled patients.ResultsOf
15 540 patients, 1.70% had prior OAG, including 2.02% of the dementia group and
1.38% of the controls. After adjusting for patient socioeconomic characteristics 
and comorbid medical disorders, dementia patients were more likely to have had
prior OAG than controls (odds ratio (OR): 1.44; 95% confidence interval (CI):
1.12-1.85; P<0.01). In addition, female dementia patients were more likely to
have had prior OAG than controls (OR: 1.93; 95% CI: 1.35-2.77; P<0.001), whereas 
no statistical difference in prior OAG between male dementia patients and
controls was found.ConclusionsFemale dementia patients were associated with a
higher proportion of prior OAG than were the controls.Eye advance online
publication, 10 July 2015; doi:10.1038/eye.2015.120.

PMID: 26160529   [PubMed - as supplied by publisher]

16. Eye (Lond). 2015 Jul 10. doi: 10.1038/eye.2015.114. [Epub ahead of print]

Intra-silicone oil injection of methotrexate at the end of vitrectomy for
advanced proliferative diabetic retinopathy.

Ghasemi Falavarjani K(1), Modarres M(1), Hadavandkhani A(1), Karimi Moghaddam

Author information: 
(1)Department of Ophthalmology, Eye Research Center, Rassoul Akram Hospital, Iran
University of Medical Sciences, Tehran, Iran.

PurposeTo evaluate the role of methotrexate (MTX) injected into the silicone oil 
at the end of pars plana vitrectomy for advanced proliferative diabetic
retinopathy (PDR).MethodsIn this prospective comparative interventional study,
eyes with severe diabetic tractional macular detachment or combined
tractional/rhegmatogenous retinal detachment were included. Standard 20 gauge
pars plana vitrectomy, and retinal reattachment was performed. In the case group,
250 μg MTX was injected into the silicone oil at the end of surgery. The rate of 
retinal re-detachment associated with fibrovascular proliferation or
proliferative vitreoretinopathy (PVR) was assessed.ResultsOverall, 38 eyes of 35 
patients (19 cases and 19 controls) were studied. The two groups were matched for
age, sex, preoperative visual acuity, and the type of surgery (vitrectomy alone
vs combined phacoemulsification/vitrectomy). Retinal re-detachment with
fibrovascular proliferation or PVR occurred in seven eyes (36.8%) in the MTX
group and eight eyes (42.1%) in the control group (P=0.74). Mean change in visual
acuity was 0.04±0.71 and 0.39±0.70 logMAR in the MTX and the control group,
respectively (P=0.14). The rate of improvement or worsening of visual acuity was 
similar between the two groups (P=0.51 and P=0.12).ConclusionIntra-silicone
injection of MTX at the end of vitrectomy for retinal detachment associated with 
severe PDR did not reduce the risk of postoperative retinal detachment due to the
fibrous or fibrovascular proliferations.Eye advance online publication, 10 July
2015; doi:10.1038/eye.2015.114.

PMID: 26160528   [PubMed - as supplied by publisher]

17. Eye (Lond). 2015 Jul 10. doi: 10.1038/eye.2015.121. [Epub ahead of print]

The effectiveness of asking multiple questions at the Royal College of
Ophthalmologists Annual Congress.

Williams GS(1).

Author information: 
(1)Department of Ophthalmology, Singleton Hospital, Swansea, UK.

PMID: 26160527   [PubMed - as supplied by publisher]

18. Eye (Lond). 2015 Jul 10. doi: 10.1038/eye.2015.125. [Epub ahead of print]

Three percent diquafosol ophthalmic solution as an additional therapy to existing
artificial tears with steroids for dry-eye patients with Sjögren's syndrome.

Yokoi N(1), Sonomura Y(1), Kato H(1), Komuro A(1), Kinoshita S(1).

Author information: 
(1)Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, 

PurposeTo investigate the long-term results of 3% diquafosol ophthalmic solution 
as an alternative therapy to existing ophthalmic solutions, including topical
immunosuppression, for the treatment of dry eye in patients with Sjögren's
syndrome.MethodsThis study involved 14 female dry-eye patients (mean age: 62.4
years) with Sjögren's syndrome who insufficiently responded to their current
therapy. In all patients, 3% diquafosol ophthalmic solution was administered six 
times daily for 12 months in substitution for artificial tears and sodium
hyaluronate ophthalmic solution. Their use of corticosteroid eye drops remained
unchanged from that prior to the treatment with diquafosol sodium. The subjective
symptoms assessed, and ocular signs including tear meniscus radius and the tear
film breakup time, and ocular-surface epithelial damage score were examined at 1,
2, 3, 4, 5, 6, 9, and 12 months after initiating treatment.ResultsAmong the
subjective symptoms, significant improvement was obtained in dryness at 2 months 
post treatment, in eye fatigue at 1, 2, 3, 4, and 12 months post treatment, and
in pain at 1, 2, 6, and 12 months post treatment. Difficulty in opening the eye, 
foreign body sensation, and redness were also significantly ameliorated at
various time-points. The tear meniscus radius and the tear film breakup time were
significantly improved throughout the observation period, and the corneal
epithelial staining scores were significantly decreased at 3 months post
treatment.ConclusionsIn dry-eye patients with Sjögren's syndrome, treatment with 
3% diquafosol ophthalmic solution improved both symptoms and signs, and that
effectiveness was maintained for 12 months.Eye advance online publication, 10
July 2015; doi:10.1038/eye.2015.125.

PMID: 26160526   [PubMed - as supplied by publisher]

19. Eye (Lond). 2015 Jul 10. doi: 10.1038/eye.2015.104. [Epub ahead of print]

Therapeutic benefit of melatonin in refractory central serous chorioretinopathy.

Gramajo AL(1), Marquez GE(1), Torres VE(2), Juárez CP(1), Rosenstein RE(3), Luna 
JD(1); Medscape.

Author information: 
(1)Centro Privado de Ojos Romagosa-Fundación VER, Córdoba, Argentina.
(2)CIECS-CONICET y Facultad de Ciencias Económicas, UNC, Córdoba, Argentina.
(3)Laboratory of Retinal Neurochemistry and Experimental Ophthalmology,
Department of Human Biochemistry, School of Medicine/CEFyBO, University of Buenos
Aires/CONICET, Buenos Aires, Argentina.

PurposeTo evaluate the efficacy and safety of melatonin for the treatment of
chronic central serous chorioretinopathy (CSCR).MethodsProspective comparative
case series. A total of 13 patients with chronic CSCR were treated for 1 month: 8
patients were treated orally with 3 mg melatonin t.i.d., and 5 with placebo. All 
patients had 20/40 or worse Early Treatment Diabetic Retinopathy Study (ETDRS)
best-corrected visual acuity (BCVA) in the affected eye or presented an
incapacitating scotoma. Most of the patients had previous failed treatments for
their condition. Observational procedures included ETDRS BCVA, and complete
ophthalmic examination. Optical coherence tomography (OCT) was performed at day 1
and week 4. Fluorescein angiography was performed at baseline only for diagnostic
purposes. Data were subjected to two-sample t-test statistical analysis. P-values
of <0.05 were considered statistically significant.ResultsAt 1-month follow-up,
BCVA significantly improved in 87.5% of patients treated with melatonin (7 of 8
patients, P<0.05). All patients showed a mean significant reduction (P<0.01) of
central macular thickness (CMT) when compared with the baseline, with 3 patients 
(37.5%) exhibiting complete resolution of subretinal fluid at 1-month follow-up. 
No significant side effects were observed. No changes in BCVA or CMT were noted
in the control group.ConclusionsThese results suggest that melatonin is safe,
well tolerated, and effective in the treatment of chronic CSCR, as it
significantly improved BCVA and CMT in patients with this pathology. Further
evaluations with longer follow-up and a larger patient population are
desirable.Eye advance online publication, 10 July 2015; doi:10.1038/eye.2015.104.

PMID: 26160525   [PubMed - as supplied by publisher]

20. Eye (Lond). 2015 Jul;29(7):986. doi: 10.1038/eye.2015.88.

The role of computerised tomography in predicting visual outcome in ocular trauma

Chaudhary R, Upendran M, Campion N, Yeung A, Blanch R, Morgan-Warren P, Gibb I,
Nelson T, Scott R.

PMID: 26156650   [PubMed - in process]

21. Eye (Lond). 2015 Jul;29 Suppl 1:S1-S11. doi: 10.1038/eye.2015.77.

Aflibercept in wet AMD beyond the first year of treatment: recommendations by an 
expert roundtable panel.

McKibbin M(1), Devonport H(2), Gale R(3), Gavin M(4), Lotery A(5), Mahmood S(6), 
Patel PJ(7), Ross A(8), Sivaprasad S(7), Talks J(9), Walters G(10).

Author information: 
(1)Ophthalmology Department, St James's University Hospital, Leeds, UK.
(2)Ophthalmology Department, Bradford Royal Infirmary, Bradford, UK.
(3)Ophthalmology Department, The York Hospital, York, UK. (4)Ophthalmology
Department, NHS Greater Glasgow and Clyde, UK. (5)Southampton General Hospital,
Southampton, UK. (6)1] Manchester Royal Eye Hospital, Central Manchester
University Hospitals NHS Foundation Trust, Manchester Academic Health Science
Centre, Manchester, UK [2] Centre for Ophthalmology & Vision Sciences, Institute 
of Human Development, University of Manchester, Manchester, UK. (7)NIHR
Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of
Ophthalmology, London, UK. (8)Bristol Eye Hospital, Bristol, UK. (9)Newcastle Eye
Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK. (10)Department of
Ophthalmology, Harrogate District Hospital, Harrogate, UK.

This paper provides expert recommendations on administration of aflibercept in
wet age-related macular degeneration (AMD) after Year 1 (Y1), based on a
roundtable discussion held in London, UK in November 2014. The goals of treatment
after Y1 are to maintain visual and anatomical gains whilst minimising treatment 
burden and using resources effectively. The treatment decision should be made at 
the seventh injection visit (assuming the label has been followed) in Y1, and
three approaches are proposed: (a) eyes with active disease on
imaging/examination but with stable visual acuity (VA) at the end of Y1 should
continue with fixed 8-weekly dosing; (b) eyes with inactive disease on
imaging/examination and stable VA should be managed using a 'treat and extend'
(T&E) regimen. T&E involves treating and then extending the interval until the
next treatment, by 2-week intervals, to a maximum of 12 weeks, provided the
disease remains inactive. If there is new evidence of disease activity, treatment
is administered and the interval to the next treatment shortened; and (c) if
there has been no disease activity for ≥3 consecutive visits, a trial of
monitoring without treatment may be appropriate, initiated at the end of Y1 or at
any time during Y2. Where possible, VA testing, OCT imaging and injection should 
be performed at the same visit. The second eye should be monitored to detect
fellow eye involvement. In bilateral disease, the re-treatment interval should be
driven by the better-seeing eye or, if the VA is similar, the eye with the more
active disease.

PMID: 26156564   [PubMed - in process]

22. Eye (Lond). 2015 Jul 3. doi: 10.1038/eye.2015.112. [Epub ahead of print]

Trabeculectomy ab interno (trabectome): yet another possibility in the treatment 
of uncontrolled glaucomatocyclitic crisis under systemic valganciclovir therapy?

Pahlitzsch M(1), Torun N(1), Gonnermann J(1), Maier AB(1), Pleyer U(1),
Bertelmann E(1), Joussen A(1), Klamann MK(1).

Author information: 
(1)Department of ophthalmology, Campus Virchow clinic, Charite University
medicine, Berlin, Germany.

PurposeTo assess the outcome of trabectome surgery in the treatment of
glaucomatocyclitic crisis (Posner-Schlossman syndrome) in patients with
uncontrolled intraocular pressure (IOP).Patients/MethodsTrabectome surgery was
performed in seven patients with diagnosed glaucomatocyclitic crisis and
uncontrolled IOP where cytomegalovirus DNA was verified by polymerase chain
reaction in aqueous humour samples. All patients were treated with oral
valganciclovir. After surgery the patients were followed-up for 12
months.ResultsMean IOP before trabectome surgery was 40±10 mm Hg (range
33-58 mm Hg). The mean number of antiglaucoma medication prior to surgery was
3.1±0.4. By the end of the 12 months, IOP in all patients was reduced to normal
level (13±1 mm Hg) and their antiglaucoma medication was decreased to 0.8±1.1. No
recurring attack of glaucomatocyclitic crisis occurred.DiscussionIn addition to
oral valganciclovir therapy, trabectome surgery seems to be a reliable and
effective tool for the management of glaucomatocyclitic crisis with uncontrolled 
IOP.Eye advance online publication, 3 July 2015; doi:10.1038/eye.2015.112.

PMID: 26139050   [PubMed - as supplied by publisher]

23. Eye (Lond). 2015 Jul 3. doi: 10.1038/eye.2015.119. [Epub ahead of print]

SSRI-associated optic neuropathy.

Lochhead J(1).

Author information: 
(1)Department of Ophthalmology, St Mary's Hospital, Newport, IOW, UK.

PurposeWe report five cases of optic neuropathy (ON) identified over a 2-year
period within an island population of 140 000. These cases display
characteristics possibly related to long-term treatment with selective serotonin 
reuptake inhibitors (SSRIs).MethodsRetrospective analysis of casenotes. Each case
has been assessed using the Naranjo algorithm to indicate likelihood of adverse
drug reaction (ADR).ResultsClinical assessment and investigation confirmed ON in 
all cases with a vascular origin suspected. SSRI cessation may help protect the
unaffected eye and in some cases recovery of vision seems possible. The Naranjo
scores indicated possible ADR in four cases and probable ADR in one
case.ConclusionsIn 2004, ~7% of the UK adult population was receiving SSRI
treatment for a range of 4.8-7.7 years. The most common ophthalmic side effect is
acute glaucoma. Currently, there remain no reports of SSRI associated ON,
although papilloedema has been reported. A potential mechanism for ischaemic
optic neuropathy (ION) has been described in relation to raised serotonin levels.
A single case of central retinal vein occlusion exists along with reports of deep
vein thrombosis (DVT) and ischaemic stroke. We recommend a review of SSRI
treatment in cases of acute ON.Eye advance online publication, 3 July 2015;

PMID: 26139049   [PubMed - as supplied by publisher]

24. Eye (Lond). 2015 Jul 3. doi: 10.1038/eye.2015.113. [Epub ahead of print]

Spectral-domain optical coherence tomography analysis of persistent subretinal
fluid after scleral buckling surgery for macula-off retinal detachment.

Gharbiya M(1), Malagola R(1), Mariotti C(2), Parisi F(1), De Vico U(1), Ganino
C(1), Grandinetti F(1).

Author information: 
(1)Department of Ophthalmology, Sapienza University, Umberto I Hospital, Rome,
Italy. (2)Department of Ophthalmology, Polytechnic University of Marche, Ancona, 

PurposeTo determine the predictive value of markers for persistent subretinal
fluid (SRF) absorption and the influence of subfoveal fluid on visual outcome
after scleral buckle (SB) surgery for rhegmatogenous retinal detachment
(RRD).Patients and methodsThis was a retrospective, observational study. We
reviewed the medical records of 64 eyes of 64 patients who underwent SB surgery
for macula-off RRD. Patients underwent clinical examination and spectral-domain
optical coherence tomography before surgery, at 1 month and every 3 months
postoperatively. The height and width of SRF bleb(s) were measured over
time.ResultsPersistent SRF at 1 month was observed in 40 eyes (62.5%). SRF blebs 
were first detected 1.7±2.2 months postoperatively. In 29 cases that could be
fully followed up, SRF blebs were completely absorbed 7.8±4.4 months
postoperatively. Resolution of fluid was associated with an improvement of VA
(P=0.003). Serial measurements of SRF bleb size showed that bleb width decreased 
significantly at all time points during the 12-month follow-up period (P<0.05),
while significant bleb height decrease occurred from postoperative sixth month
only (P<0.05). There was no correlation between VA outcomes and subfoveal bleb
height or width (P>0.05). The cut-off value of the bleb width-to-height ratio
level for predicting bleb absorption at 6 months was 7, with 89% sensitivity and 
83% specificity.ConclusionsVisual improvement may occur with late resolution of
residual subfoveal fluid. A bleb width-to-height ratio >7 indicates a higher risk
of SRF to persist beyond 6 months after surgery.Eye advance online publication, 3
July 2015; doi:10.1038/eye.2015.113.

PMID: 26139048   [PubMed - as supplied by publisher]

25. Eye (Lond). 2015 Jul 3. doi: 10.1038/eye.2015.105. [Epub ahead of print]

Stability and safety of MA50 intraocular lens placed in the sulcus.

Kemp PS(1), Oetting TA(2).

Author information: 
(1)Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa
City, IA, USA. (2)1] Department of Ophthalmology, University of Iowa Hospitals
and Clinics, Iowa City, IA, USA [2] Department of Ophthalmology, Veterans
Administration Medical Center, Coralville, IA, USA.

PurposeTo describe the safety and stability of sulcus placement of the MA50
intraocular lens (IOL).Patients and methodsConsecutive patients with MA50 IOLs
placed in the sulcus at the University of Iowa Hospitals and Clinics, Iowa City, 
Iowa, USA, from 1997 to 2012 were identified. Inclusion criteria included
patients with over 4 weeks of follow-up data. AEL was compared with incidence of 
IOL decentration using at two-tailed Student's t-test.ResultsFifty eyes of 49
patients meeting the inclusion criteria were identified. Four weeks
post-operatively, the average best-corrected visual acuity was 20/30. IOL
decentration occurred in 14% of patients; patients with decentered IOLs had a
significantly longer average AEL (25.37 mm) than patients whose IOL remained
centered (23.94 mm, P=0.017). Other complications included
uveitis-glaucoma-hyphema syndrome (12%), iritis (8%), and glaucoma (6%). There
were no cases of pigment dispersion syndrome or need for lens exchange. Twelve
eyes (24%) had intra-operative optic capture by the anterior capsule, none of
which had post-operative decentration.ConclusionThe MA50 IOL is a reasonable,
stable option for placement in the sulcus, with a low-risk profile; however, in
eyes with longer AEL and presumably larger anterior segment, surgeons should
consider placing an IOL with longer haptic distance than the MA50 to maintain
centration. Optic capture of the MA50 IOL by the anterior capsule should be
considered for longer eyes, as it is protective against decentration.Eye advance 
online publication, 3 July 2015; doi:10.1038/eye.2015.105.

PMID: 26139047   [PubMed - as supplied by publisher]

26. Eye (Lond). 2015 Jul 3. doi: 10.1038/eye.2015.116. [Epub ahead of print]

Electroretinography can provide objective assessment of inner retinal function
prior to atrophic change on OCT.

Mahroo OA(1).

Author information: 
(1)1] Department of Ophthalmology, King's College London, London, UK [2]
Moorfields Eye Hospital, London, UK [3] Physiology, Development and Neuroscience,
University of Cambridge, Cambridge, UK.

PMID: 26139046   [PubMed - as supplied by publisher]

27. Eye (Lond). 2015 Jul 3. doi: 10.1038/eye.2015.117. [Epub ahead of print]

Transient retinal artery occlusion: the potential utility and limitations of

Yusuf IH(1), Smith R(1), Patel CK(2).

Author information: 
(1)Department of Ophthalmology, Stoke Mandeville Hospital, Aylesbury, UK. (2)The 
Oxford Eye Hospital, West Wing, John Radcliffe Hospital, Headington, UK.

PMID: 26139045   [PubMed - as supplied by publisher]

28. Eye (Lond). 2015 Jun 26. doi: 10.1038/eye.2015.107. [Epub ahead of print]

Comparison of two- and three-point sutures for advancing the levator aponeurosis 
in Asian eyelids.

Kim YS(1), Yoon JS(2), Jang SY(3).

Author information: 
(1)Department of Ophthalmology, Soonchunhyang University Bucheon Hospital,
Soonchunhyang University College of Medicine, Bucheon, Korea. (2)Department of
Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei
University College of Medicine, Seoul, Korea. (3)1] Department of Ophthalmology, 
Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of
Medicine, Bucheon, Korea [2] Yonsei University Graduate School of Medicine,
Seoul, Korea.

PurposeTo compare the functional and cosmetic outcomes of two- and three-point
sutures for advancing the levator aponeurosis in blepharoptosis surgery on
Asians.Patients and methodsThis retrospective study examined 60 Asian patients
with blepharoptosis who had undergone advancement of the levator aponeurosis: 34 
patients (46 eyelids) had ptosis correction using the two-point suture technique 
and 26 patients (41 eyelids) had ptosis correction using the three-point suture
technique. The postoperative marginal reflex distance (MRD1), lid height
difference, and eyelid contour were evaluated.ResultsTwenty-seven (79.4%) of the 
34 patients in the two-point group and 19 (73.1%) of 26 patients in the
three-point group had a postoperative MRD1 of 2-4 mm, lids within 0.5 mm of each 
other, and a satisfactory eyelid contour; this difference was not significant.
The rate of reoperation did not differ significantly between the two
groups.ConclusionTwo- and three-point sutures for advancing the levator
aponeurosis were equally effective for correcting blepharoptosis in Asians.Eye
advance online publication, 26 June 2015; doi:10.1038/eye.2015.107.

PMID: 26113504   [PubMed - as supplied by publisher]

29. Eye (Lond). 2015 Jun 26. doi: 10.1038/eye.2015.98. [Epub ahead of print]

Long-term outcomes of phakic patients with diabetic macular oedema treated with
intravitreal fluocinolone acetonide (FAc) implants.

Yang Y(1), Bailey C(1), Holz FG(1), Eter N(1), Weber M(1), Baker C(1), Kiss S(1),
Menchini U(1), Ruiz Moreno JM(1), Dugel P(1), Lotery A(1).

Author information: 
(1)Royal Wolverhampton Hospitals NHS Trust, New Cross, Wolverhampton, UK.

PurposeDiabetic macular oedema (DMO) is a leading cause of blindness in
working-age adults. Slow-release, nonbioerodible fluocinolone acetonide (FAc)
implants have shown efficacy in the treatment of DMO; however, the National
Institute for Health and Care Excellence recommends that FAc should be used in
patients with chronic DMO considered insufficiently responsive to other available
therapies only if the eye to be treated is pseudophakic. The goal of this
analysis was to examine treatment outcomes in phakic patients who received
0.2 μg/day FAc implant.MethodsThis analysis of the phase 3 FAME (Fluocinolone
Acetonide in Diabetic Macular Edema) data examines the safety and efficacy of FAc
implants in patients who underwent cataract extraction before (cataract before
implant (CBI) group) or after (cataract after implant (CAI) group) receiving the 
implant. The data were further examined by DMO duration.ResultsBest corrected
visual acuity (BCVA) after 36 months was comparable in the CAI and CBI groups.
Both the percentage of patients gaining ≥3 lines of vision and mean change in
BCVA letter score were numerically greater in the CAI group. In addition, most
patients who underwent cataract surgery experienced a net gain in BCVA from
presurgery baseline as well as from original study baseline.ConclusionsThese data
support the use of 0.2 μg/day FAc implants in phakic as well as in pseudophakic
patients. These findings will serve as a pilot for design of future studies to
evaluate the potential protective effect of FAc implants before cataract surgery 
in patients with DMO and cataract.Eye advance online publication, 26 June 2015;

PMID: 26113503   [PubMed - as supplied by publisher]

30. Eye (Lond). 2015 Jun 26. doi: 10.1038/eye.2015.93. [Epub ahead of print]

Diverse clinical phenotypes associated with a nonsense mutation in FAM161A.

Rose AM(1), Sergouniotis P(2), Alfano G(1), Muspratt-Tucker N(1), Barton S(3),
Moore AT(4), Black G(3), Bhattacharya SS(1), Webster AR(4).

Author information: 
(1)Department of Genetics, UCL Institute of Ophthalmology, London, UK. (2)1]
Department of Genetics, UCL Institute of Ophthalmology, London, UK [2] Department
of Genetic Medicine, Central Manchester University Hospitals, Manchester, UK.
(3)Department of Genetic Medicine, Central Manchester University Hospitals,
Manchester, UK. (4)1] Department of Genetics, UCL Institute of Ophthalmology,
London, UK [2] Department of Medical Retina Service, Moorfields Eye Hospital,
London, UK.

PURPOSE: Mutations in the FAM161A gene have been reported in association with
autosomal recessive retinitis pigmentosa (arRP) in several ethnic populations.
This study aimed to assess the prevalence of FAM161A-related retinopathy in a
British cohort and to characterise the phenotype associated with mutations in
this gene.
METHODS: The FAM161A coding region and intron-exon boundaries were screened by
Sanger sequencing in 120 retinitis pigmentosa (RP) patients (with likely
autosomal recessive inheritance) in whom mutations in other known major RP genes 
have been ruled out by commercially available testing. Homozygosity mapping was
performed in one consanguineous family, and high-throughput sequencing of
candidate genes was performed to identify disease-associated changes. Clinical
assessment of affected individuals included perimetry testing, fundus
autofluorescence imaging, and optical coherence tomography.
RESULTS: Two patients of British origin with a homozygous mutation in FAM161A
(c.1309A>T, p.Arg437*) were identified by Sanger sequencing. Homozygosity mapping
and subsequent high-throughput sequencing analysis identified a further family of
Pakistani origin with the same genotype. Clinical examination of affected members
of these families revealed that this mutation was associated with a diverse
clinical phenotype, ranging from mild disease with preservation of central acuity
to severe visual impairment.
CONCLUSIONS: Homozygosity for the c.1309A>T, p.Arg437* variant in FAM161A is a
relatively common cause of arRP. The mutation occurs in diverse ethnic
populations, associated with typical retinitis pigmentosa with disease onset
usually in the second or third decade of life.Eye advance online publication, 26 
June 2015; doi:10.1038/eye.2015.93.

PMID: 26113502   [PubMed - as supplied by publisher]