Journal Contents

Am Jour Ophthalmol
Br J Ophthalmol
Can J Ophthalmol
J Cat Ref Surg
Cornea
Curr Eye Res
Eur J Ophthalmol
Eye
J Glaucoma
JAMA Ophthalmol
Graefes Ophthalmol
Indian J Ophthalmol
Int Ophthalmol Clin
Invest Ophth Vis Sci
Jpn J Ophthalmol
JPOS
Korean J Ophthal
J Neuroophthalmol
Ophthalmic Epidemiol
Ophthalmic Genet
Ophthal Plast Rec Surg
Ophthalmic Res
Ophthalmologica
Ophthalmology
Retina
Surv Ophthalmol
Ophthalmology Review Journal
Eye[JOUR] Established 1995
1. Eye (Lond). 2015 Aug 21. doi: 10.1038/eye.2015.146. [Epub ahead of print]

The accuracy of the Edinburgh visual loss diagnostic algorithm.

Goudie C(1), Khan A(1), Lowe C(2), Wright M(1,)(2).

Author information: 
(1)Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh,
Scotland. (2)College of Medicine and Veterinary Medicine, University of
Edinburgh, Edinburgh, Scotland.

PurposeTo assess the diagnostic accuracy of the Edinburgh visual loss
algorithm.MethodsThis was a prospective study. Patients referred to the Edinburgh
Eye Pavilion with visual loss were assessed using the Edinburgh Visual Loss
Algorithm by either a medical student, an inexperienced ophthalmology trainee or 
an optometrist in the Lothian Optometry Treat and Teach clinic. Accuracy of this 
'algorithm-assisted' diagnosis was then compared with the 'gold-standard'
diagnosis, made by an experienced ophthalmologist. Accuracy of the pre-algorithm 
diagnosis, made by the referrer, was also compared with the algorithm-assisted
diagnosis.ResultsAll patients referred with visual loss were eligible for
inclusion. Seventy patients were assessed; two were excluded. Pre-algorithm
accuracy of referral of patients with visual loss was 51% (30/59). Overall, the
algorithm-assisted diagnosis was correct 84% (57/68) of the time. The algorithm
correctly diagnosed: retina in 71% of cases (5/7), macula in 86% (25/29),
peripheral retina in 100% (2/2), optic nerve in 71% (5/7), media opacity in 89%
(16/18), post chiasmal in 100% (4/4), and refractive error in 0% (0/1). Accuracy 
of diagnosis was similar for each algorithm user; medical student 81%,
inexperienced ophthalmology trainee 84% and optometrist 92%.DiscussionThe
baseline diagnostic accuracy of clinicians who are inexperienced in ophthalmology
rose from 51 to 84% when patients were assessed using the algorithm. This
algorithm significantly improves the diagnostic accuracy of referrals to the
hospital eye service, regardless of the user's previous ophthalmic experience. We
hope we have demonstrated its potential as a learning tool for inexperienced
clinicians.Eye advance online publication, 21 August 2015;
doi:10.1038/eye.2015.146.

PMID: 26293143   [PubMed - as supplied by publisher]


2. Eye (Lond). 2015 Aug 21. doi: 10.1038/eye.2015.144. [Epub ahead of print]

Periodic acid-Schiff staining demonstrates fungi in chronic anterior blepharitis.

Dadaci Z(1), Kılınç F(2), Ozer TT(3), Sahin GO(4), Acir NO(1), Borazan M(1).

Author information: 
(1)Department of Ophthalmology, Mevlana University School of Medicine, Konya,
Turkey. (2)Department of Pathology, Mevlana University School of Medicine, Konya,
Turkey. (3)Department of Microbiology, Mevlana University School of Medicine,
Konya, Turkey. (4)Department of Dermatology, Mevlana University School of
Medicine, Konya, Turkey.

PurposeTo evaluate the presence of fungi in patients with chronic anterior
blepharitis with periodic acid-Schiff (PAS) staining of the eyelashes in addition
to the conventional methods of fungal cultures and direct
microscopy.MethodsNineteen patients with chronic anterior blepharitis of
seborrheic or mixed seborrheic/staphylococcal type and 11 healthy age- and
sex-matched controls were included in this prospective, nonrandomized,
cross-sectional study. Blepharitis was diagnosed based on clinical evidence of
greasy scales between the cilia, lid margin erythema, conjunctival hyperemia,
telangiectasia, thickening, or irregularity of the eyelid margins by slit-lamp
biomicroscopy. Eyelash samples were obtained by epilation with a sterile forceps 
and evaluated with PAS staining, fungal cultures, and direct microscopy.ResultsWe
demonstrated fungal elements with PAS staining in 79% of the blepharitis group
(hyphae and/or spores) and 18% of the control group. The difference was
statistically significant (P=0.002). Four patients in the blepharitis group (21%)
had positive cultures for fungi. The isolated fungi were Penicillium species (2
cases), Candida species (1 case), and Trichophyton verrucosum (1 case). Direct
microscopic examination revealed Demodex mites in 42.1% of the blepharitis group.
No culture growth or Demodex mites were observed in the control
group.ConclusionsWe have shown fungi with PAS staining in the majority of
patients with chronic anterior blepharitis. Further controlled studies are
necessary to clarify the role of fungi in the etiopathogenesis of blepharitis.Eye
advance online publication, 21 August 2015; doi:10.1038/eye.2015.144.

PMID: 26293142   [PubMed - as supplied by publisher]


3. Eye (Lond). 2015 Aug 21. doi: 10.1038/eye.2015.139. [Epub ahead of print]

Blepharitis: remains a diagnostic enigma. A role for tea tree oil shampoo?

Hossain P(1,)(2), Konstantopoulos A(1,)(2).

Author information: 
(1)Clinical Experimental Sciences, Faculty of Medicine, University of
Southampton, Southampton, UK. (2)Eye Unit, Southampton General Hospital,
University Hospital Southampton NHS Foundation Trust, Southampton, UK.

PMID: 26293141   [PubMed - as supplied by publisher]


4. Eye (Lond). 2015 Aug 21. doi: 10.1038/eye.2015.152. [Epub ahead of print]

Hyperopic refractive errors as a prognostic factor in intermittent exotropia
surgery.

Kim MK(1), Kim US(1), Cho MJ(1), Baek SH(1).

Author information: 
(1)Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research
Institute, Konyang University College of Medicine, Seoul, Korea.

PurposeTo evaluate and compare surgical outcomes with respect to refractive
errors in strabismus surgery for the treatment of intermittent exotropia
(IXT).MethodsThe medical records of patients with IXT who were treated by one
surgeon from January 2005 and June 2011 were reviewed. Three hundred and
thirty-three IXT patients were included and divided into three groups according
to preoperative refractive error: IXT with hyperopia (group I), IXT with
emmetropia (group II), and IXT with myopia (group III). The surgical outcomes
with respect to sensory and motor criteria were compared among the three
groups.ResultsThe surgical success rates according to motor criteria and sensory 
and motor criteria combined were higher in groups I (29 patients) and III (124
patients) than in group II (180 patients) at postoperative 3 and 6 months and at 
the last follow-up. Stereopsis was significantly better in groups II and III than
in group I preoperatively (P=0.002 by one-way analysis of variance test);
however, the difference was not significant postoperatively. Twenty patients in
group I (69.0%) were prescribed undercorrected hyperopic spectacles
postoperatively, while only 22 patients in group III (17.7%) were prescribed
spectacles with more myopic power than their refractive errors.ConclusionIn the
surgical treatment of IXT, hyperopia was not an indicator of poor prognosis.
Taking into consideration the age effect, follow-up period after IXT surgery, and
stereopsis improvement, hyperopic refractive error is rather a good prognostic
factor.Eye advance online publication, 21 August 2015; doi:10.1038/eye.2015.152.

PMID: 26293140   [PubMed - as supplied by publisher]


5. Eye (Lond). 2015 Aug 21. doi: 10.1038/eye.2015.162. [Epub ahead of print]

Peripheral lamina cribrosa depth in primary open-angle glaucoma: a swept-source
optical coherence tomography study of lamina cribrosa.

Kim YW(1), Kim DW(1), Jeoung JW(1), Kim DM(1), Park KH(1).

Author information: 
(1)Department of Ophthalmology, Seoul National University Hospital, Seoul
National University College of Medicine, Seoul, Korea.

PurposeTo investigate peripheral lamina cribrosa depth (PLCD) and its
vertical-horizontal difference in eyes with primary open-angle glaucoma
(POAG).MethodsPatients with POAG (n=90 eyes) and age-matched healthy individuals 
(n=90 eyes) underwent swept-source optical coherence tomography (SS-OCT) scans
centered at the optic discs. The PLCD was defined as the vertical distance
between the most peripheral visible end of anterior lamina cribrosa (LC) surface 
and the reference plane connecting the Bruch's membrane openings. The PLCD in
each quadrant region and the vertical-horizontal PLCD difference were compared
between the POAG and healthy eyes. The clinical factors associated with increased
PLCD were evaluated.ResultsThe PLCD was significantly larger in the POAG eyes
than the control eyes at the horizontal (P=0.034) and vertical (P=0.001)
meridians. The vertical PLCD was significantly larger than the horizontal PLCD,
both in the POAG eyes (P<0.001) and in the control eyes (P=0.003). However, the
vertical-horizontal PLCD difference was significantly larger in the POAG eyes
(47±60 μm) than in the control eyes (18±54 μm, P=0.001). Multivariate regression 
showed a significant association of male gender (P=0.005), increased baseline IOP
(P=0.043), and decreased MD of VF (P=0.025) with increased PLCD.ConclusionsThe
peripheral LC was displaced more posteriorly in the POAG eyes compared with the
age-matched healthy eyes. In the POAG eyes, the peripheral LC was displaced more 
posteriorly at the vertical meridian than at the horizontal meridian. The
peripheral LC in the vertical meridian might have increased IOP-related strain
(deformation) compared with horizontal meridian in glaucomatous eyes.Eye advance 
online publication, 21 August 2015; doi:10.1038/eye.2015.162.

PMID: 26293139   [PubMed - as supplied by publisher]


6. Eye (Lond). 2015 Aug 21. doi: 10.1038/eye.2015.154. [Epub ahead of print]

Advances in retinal ganglion cell imaging.

Balendra SI(1), Normando EM(1,)(2), Bloom PA(2), Cordeiro MF(1,)(2).

Author information: 
(1)Glaucoma and Retinal Neurodegeneration Group, Department of Visual
Neuroscience, UCL Institute of Ophthalmology, London, UK. (2)Imperial College
Ophthalmology Research Group (ICORG), Western Eye Hospital, Imperial College
Healthcare Trust, London, UK.

Glaucoma is one of the leading causes of blindness worldwide and will affect 79.6
million people worldwide by 2020. It is caused by the progressive loss of retinal
ganglion cells (RGCs), predominantly via apoptosis, within the retinal nerve
fibre layer and the corresponding loss of axons of the optic nerve head. One of
its most devastating features is its late diagnosis and the resulting
irreversible visual loss that is often predictable. Current diagnostic tools
require significant RGC or functional visual field loss before the threshold for 
detection of glaucoma may be reached. To propel the efficacy of therapeutics in
glaucoma, an earlier diagnostic tool is required. Recent advances in retinal
imaging, including optical coherence tomography, confocal scanning laser
ophthalmoscopy, and adaptive optics, have propelled both glaucoma research and
clinical diagnostics and therapeutics. However, an ideal imaging technique to
diagnose and monitor glaucoma would image RGCs non-invasively with high
specificity and sensitivity in vivo. It may confirm the presence of healthy RGCs,
such as in transgenic models or retrograde labelling, or detect subtle changes in
the number of unhealthy or apoptotic RGCs, such as detection of apoptosing
retinal cells (DARC). Although many of these advances have not yet been
introduced to the clinical arena, their successes in animal studies are
enthralling. This review will illustrate the challenges of imaging RGCs, the main
retinal imaging modalities, the in vivo techniques to augment these as specific
RGC-imaging tools and their potential for translation to the glaucoma clinic.Eye 
advance online publication, 21 August 2015; doi:10.1038/eye.2015.154.

PMID: 26293138   [PubMed - as supplied by publisher]


7. Eye (Lond). 2015 Aug 14. doi: 10.1038/eye.2015.147. [Epub ahead of print]

Impact of cataract surgery on vision-related life performances: the usefulness of
Real-Life Vision Test for cataract surgery outcomes evaluation.

Ni W(1), Li X(1), Hou Z(1), Zhang H(2), Qiu W(1), Wang W(1).

Author information: 
(1)1] Department of Ophthalmology, Peking University Third Hospital, Beijing,
China [2] Key Laboratory of Vision Loss and Restoration, Ministry of Education,
Beijing, China. (2)Research Center of Clinical Epidemiology, Peking University
Third Hospital, Beijing, China.

PurposeReal-Life Vision Test (RLVT) is a newly developed performance-based
measures of functional vision. This present study is designed to determine
whether it could be a meaningful assessment for cataract surgery outcomes
evaluation.Patients and methodsAge-related cataract patients (56) who scheduled
for bilateral cataract surgery and 44 age-matched controls were evaluated by four
types of measurements: (1) demographic, medical, cognitive and depressive
evaluation, and the reaction time testing; (2) clinical measures (visual acuity, 
contrast sensitivity, stereopsis, and color perception); (3) the 25-item National
Eye Institute's Visual Functioning Questionnaire (NEI-VFQ); (4) the RLVT.
Spearman's coefficients and multiple regression analysis were conducted to
investigate the relationship among RLVT, clinical measures, and self-report
assessment of visual function.ResultsThe results of RLVT, clinical measures, and 
NEI-VFQ total scores were improved significantly after cataract surgery. There
were no differences between control subjects and post-surgery patients with
respect to NEI-VFQ-25 total scores, self-rating depression scale scores and three
tasks of RLVT. Change of RLVT was significantly associated with the change of
clinical measures in the cataract group. Multiple regression analysis
demonstrated that change of distance, intermediate, and near visual acuity, and
binocular contrast sensitivity were significant predictors of improvements of
RLVT.ConclusionsCataract surgery could improve real-world visual ability
effectively for cataract patients. Our study highlights the potential usefulness 
of RLVT as an adjunct to the current outcomes evaluation system for cataract
surgery. The use of RLVT combined with clinical and self-survey methods may be
the comprehensive strategy to manifest the impact of cataract surgery on
patients' overall vision-related quality of life.Eye advance online publication, 
14 August 2015; doi:10.1038/eye.2015.147.

PMID: 26272444   [PubMed - as supplied by publisher]


8. Eye (Lond). 2015 Aug 14. doi: 10.1038/eye.2015.131. [Epub ahead of print]

Intravitreal anti-vascular endothelial growth factor monotherapy for large
submacular hemorrhage secondary to neovascular age-related macular degeneration.

Kim HS(1), Cho HJ(1), Yoo SG(1), Kim JH(1), Han JI(1), Lee TG(1), Kim JW(1);
Medscape.

Author information: 
(1)Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research
Institute, Konyang University College of Medicine, Seoul, South Korea.

PurposeTo evaluate the efficacy of anti-vascular endothelial growth factor (VEGF)
monotherapy for large submacular hemorrhage (SMH) secondary to neovascular
age-related macular degeneration (nAMD).MethodsA total of 49 treatment-naive
patients (49 eyes) with large SMH (more than five disc areas (DAs)) secondary to 
nAMD were retrospectively included. All patients were treated with an initial
series of 3 monthly intravitreal anti-VEGF injections, followed by as-needed
injections. At the 12-month follow-up, changes in best-corrected visual acuity
(BCVA), hemorrhage area, central foveal thickness, and development of vitreous
hemorrhage after treatment were evaluated.ResultsThe mean SMH area was 13.9±8.8
disk areas (DAs) and mean symptom duration was 7.25±5.9 days at baseline. The
mean number of injections was 4.49±1.61. Twelve months after treatment, the mean 
BCVA significantly improved from 1.14±0.61 logarithm of the minimum angle of
resolution (logMAR; 20/276, Snellen equivalent) to 0.82±0.53 logMAR (20/132;
P=0.002). Twenty-four eyes (49%) showed improvement of more than three lines of
BCVA at 12 months after treatment. Baseline BCVA (odds ratio (OR), 5.119; 95%
confidence interval (CI), 1.993-9.545; P=0.004), duration of symptoms (OR, 0.727;
95% CI, 0.332-0.952; P=0.024), hemorrhage area (OR, 0.892; 95% CI, 0.721-0.965;
P=0.011), and baseline central foveal thickness (OR, 0.881; 95% CI, 0.722-0.945; 
P=0.032) were significantly associated with good visual acuity 12 months after
treatment.ConclusionsIntravitreal anti-VEGF monotherapy is a valuable treatment
option for large SMH secondary to nAMD.Eye advance online publication, 14 August 
2015; doi:10.1038/eye.2015.131.

PMID: 26272443   [PubMed - as supplied by publisher]


9. Eye (Lond). 2015 Aug 7. doi: 10.1038/eye.2015.135. [Epub ahead of print]

The incidence of unexplained visual loss following removal of silicone oil.

Moya R(1), Chandra A(2), Banerjee PJ(2), Tsouris D(2), Ahmad N(3), Charteris
DG(2).

Author information: 
(1)1] Moorfields Eye Hospital NHS Foundation Trust, London, UK [2] Fundación
Oftalmológica Los Andes, Santiago, Chile. (2)Moorfields Eye Hospital NHS
Foundation Trust, London, UK. (3)1] Moorfields Eye Hospital NHS Foundation Trust,
London, UK [2] Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.

PurposeTo assess the incidence and clinical features of unexpected visual loss
after removal of silicone oil (ROSO).Patients and methodsA retrospective
cross-sectional observational study of 421 consecutive eyes, which underwent
silicone oil removal at one institution over a 2-year period.ResultsFourteen
(3.3%) patients, (12 male, mean age of 53.1 years) suffered unexplained visual
loss. In these eyes, the mean duration of silicone oil fill was 141 days (range
76-218). The mean loss of visual acuity was 3.7 (range 2-6) Snellen lines (SL) at
1 month, 3.5 (2-6) SL at 3 months and 2.91 (0-6) SL at 6 months. The change from 
preoperative visual acuity was statistically significant at all visits (P=0.02). 
Subgroup analysis of 20 fovea-sparing giant retinal tear (GRT) detachments,
observed 10 (50%) cases of visual loss after ROSO. Electrodiagnostic testing
suggested predominantly macular dysfunction, with optic nerve involvement in one 
case. Five of the 14 cases had variable recovery of vision.ConclusionThere is a
3.3% overall incidence of visual loss following ROSO with a high rate (50%)
observed in maculae on GRT detachments. Although recovery of visual acuity is
seen in a minority of cases, visual loss after ROSO remains a serious and
unexplained concern for vitreoretinal surgeons.Eye advance online publication, 7 
August 2015; doi:10.1038/eye.2015.135.

PMID: 26248526   [PubMed - as supplied by publisher]


10. Eye (Lond). 2015 Aug;29(8):1027-35. doi: 10.1038/eye.2015.51. Epub 2015 Aug 7.

Prognosis of uveal melanoma based on race in 8100 patients: The 2015 Doyne
Lecture.

Shields CL(1), Kaliki S(2), Cohen MN(1), Shields PW(1), Furuta M(1), Shields
JA(1).

Author information: 
(1)Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,
Philadelphia, PA, USA. (2)1] Ocular Oncology Service, Wills Eye Hospital, Thomas 
Jefferson University, Philadelphia, PA, USA [2] Dr Kaliki currently practices at 
the Ocular Oncology Service, L.V. Prasad Eye Institute, Hyderabad, India.

A retrospective, nonrandomized, interventional case series of 8100 patients with 
uveal melanoma were evaluated for melanoma-related metastasis based on patient
race. The patient race was Caucasian (n=7918, 98%), Hispanic (n=105, 1%), Asian
(n=44, <1%), or African American (n=33, <1%). On the basis of race (Caucasian,
Hispanic, Asian, and African American), significant differences were noted in
mean age at presentation (58, 48, 44, and 52 years; P<0.001), distance of
posterior tumor margin to foveola (5, 5, 6, and 4 mm; P<0.001), distance of
posterior tumor margin to optic disc (5, 5, 6, and 4 mm) (P<0.001), tumor base
(11, 12, 12, and 13 mm; P<0.001), tumor thickness (5.4, 7.1, 6.5, and 7.5 mm;
P<0.001), intraocular hemorrhage (10, 14, 11, and 24%; P=0.02), and rupture of
Bruch's membrane (20, 27, 39, and 36%; P=0.001). On the basis of multivariate
analysis, the rate of metastasis increased with increasing age (P<0.001), ciliary
body location (P<0.001), increasing tumor base (P<0.001), increasing tumor
thickness (P<0.001), pigmented tumor (P=0.001), subretinal fluid (P=0.001),
intraocular hemorrhage (P=0.045), and extraocular extension (P=0.036).
Kaplan-Meier estimates of metastasis at 3, 5, and 10 were 8, 15, and 25% in
Caucasians; 13, 13, and 13% in Hispanics; 4, 4, and 36% in Asians; and 8, 8, and 
8% in African Americans. Compared with Caucasians, despite relative risk for
metastasis of 0.31 for African Americans, 0.73 for Hispanics, and 1.42 for
Asians, there was no statistical difference in metastasis, or death from uveal
melanoma based on race. In summary, uveal melanoma showed similar prognosis for
all races.

PMCID: PMC4541345 [Available on 2016-08-01]
PMID: 26248525   [PubMed - in process]


11. Eye (Lond). 2015 Jul 31. doi: 10.1038/eye.2015.136. [Epub ahead of print]

Comment on 'Gas tamponade combined with laser photocoagulation therapy for
congenital optic disc pit maculopathy'.

Raman R(1), Delhiwala K(1).

Author information: 
(1)Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai,
India.

PMID: 26228293   [PubMed - as supplied by publisher]


12. Eye (Lond). 2015 Jul 31. doi: 10.1038/eye.2015.141. [Epub ahead of print]

Lens parameters as predictors of intraocular pressure changes after
phacoemulsification.

Moghimi S(1), Abdi F(2), Latifi G(2), Fakhraie G(2), Ramezani F(2), He M(3), Lin 
SC(4).

Author information: 
(1)1] Department of Ophthalmology, Farabi Eye Hospital, Tehran University of
Medical Science, Tehran, Iran [2] Koret Vision Center, University of California, 
San Francisco Medical School, San Francisco, CA, USA. (2)Department of
Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Science, Tehran,
Iran. (3)State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun 
Yat-sen University, Guangzhou, China. (4)Koret Vision Center, University of
California, San Francisco Medical School, San Francisco, CA, USA.

PurposeTo evaluate intraocular pressure (IOP) change after cataract surgery in
non-glaucomatous eyes with narrow and open angles (OAs) and its relation to novel
lens parameters measured by anterior segment optical coherence tomography
(AS-OCT).SettingUniversity affiliated hospital, Farabi Eye Hospital, Tehran,
Iran.DesignProspective interventional case series.MethodsIn this prospective
study, 85 non-glaucomatous eyes underwent phacoemulsification and lens
implantation. Thirty-nine eyes had OAs and 46 eyes had narrow angles (NAs). IOP
and biometric parameters were measured by AS-OCT preoperatively and 3 months
after surgery. Change in IOP and its relation to biometric parameters, including 
lens vault (LV), anterior vault (AV), defined as the sum of the LV and the ACD,
and relative LV (rLV), defined as the ratio of the LV to the AV, were evaluated. 
The main outcome measure was degree of IOP change after
phacoemulsification.ResultsOf the 85 patients included in the analysis, 35 were
male and 50 were female with an overall mean age of 62.2±8.9 years. The average
IOP reduction was -4.95±2.26 mm Hg, from a preoperative mean of 17.12±2.47 mm Hg,
at 3 months after cataract surgery. The amount of IOP reduction was significantly
greater in the NA compared with the OA group. In multivariate linear regression
analysis, preoperative IOP and AV were significantly associated with IOP decrease
(all ≤0.03).ConclusionCataract surgery results in IOP reduction in both OA and NA
eyes. The amount of IOP reduction is related to AV.Eye advance online
publication, 31 July 2015; doi:10.1038/eye.2015.141.

PMID: 26228292   [PubMed - as supplied by publisher]


13. Eye (Lond). 2015 Jul 31. doi: 10.1038/eye.2015.142. [Epub ahead of print]

Month-6 primary outcomes of the READ-3 study (Ranibizumab for Edema of the mAcula
in Diabetes-Protocol 3 with high dose).

Do DV(1), Sepah YJ(1), Boyer D(2), Callanan D(3), Gallemore R(4), Bennett M(5),
Marcus DM(6), Halperin L(7), Sadiq MA(1), Rajagopalan N(1), Campochiaro PA(8),
Nguyen QD(1).

Author information: 
(1)Stanley M. Truhlsen Eye Institute, Carl Camras Center for Innovative Clinical 
Research, University of Nebraska Medical Center, Omaha, NE, USA. (2)Retina
Vitreous Associates, Beverly Hills, CA, USA. (3)Texas Retina Associates,
Arlington, TX, USA. (4)Retina Macula Institute, Torrance, CA, USA. (5)Retina
Institute of Hawaii, Honolulu, HI, USA. (6)Southeast Retina Center, Augusta, GA, 
USA. (7)Retina Group of Florida, Fort Lauderdale, FL, USA. (8)Wilmer Eye
Institute, Johns Hopkins University, Baltimore, MD, USA.

PurposeTo compare 2.0 mg ranibizumab (RBZ) injections with 0.5 mg RBZ for eyes
with center-involved diabetic macular edema (DME) and a central subfield
thickness (CFT) of ≥250 μm on time-domain optical coherence
tomography.DesignRandomized, controlled, multicenter clinical
trial.MethodsEligible eyes were randomized in a 1:1 ratio to 0.5 mg (n=77) or
2.0 mg (n=75) RBZ. Study eyes received 6-monthly injections.Main outcome
measuresThe primary outcome measure was the mean change in best corrected visual 
acuity (BCVA) at month 6. Secondary outcomes included the incidence and severity 
of systemic and ocular adverse events and the mean change in CFT from
baseline.ResultsIn all, 152 eyes (152 patients) were randomized in the study. At 
month 6, the mean improvement from baseline BCVA was +9.43 letters in the 0.5 mg 
RBZ group and +7.01 letters in the 2.0 mg RBZ group (P=0.161). At month 6, one
death occurred in the 0.5 mg RBZ group and three deaths in the 2.0 mg RBZ group, 
all due to myocardial infarction in subjects with a prior history of heart
disease. Mean CFT was reduced by 168.58 μm in the 0.5 mg RBZ group and by
159.70 μm in the 2.0 mg RBZ group (P=0.708).ConclusionsThere was no statistically
significant difference in the mean number of letters gained between the 0.5 and
2.0 mg RBZ groups through month 6. In this DME study population, high-dose RBZ
does not appear to provide additional benefit over 0.5 mg RBZ.Eye advance online 
publication, 31 July 2015; doi:10.1038/eye.2015.142.

PMID: 26228291   [PubMed - as supplied by publisher]


14. Eye (Lond). 2015 Jul 31. doi: 10.1038/eye.2015.137. [Epub ahead of print]

Response to: 'Comment on Gas tamponade combined with laser photocoagulation
therapy for congenital optic disc pit maculopathy'.

Lei L(1), Li T(1), Ding X(1), Ma W(1), Zhu X(1), Atik A(2), Hu Y(1), Tang S(3).

Author information: 
(1)State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun
Yat-sen University, Guangzhou, China. (2)Royal Victorian Eye and Ear Hospital,
Melbourne, Victoria, Australia. (3)1] State Key Laboratory of Ophthalmology,
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China [2] Aier
School of Ophthalmology, Central South University, Changsha, China.

PMID: 26228290   [PubMed - as supplied by publisher]


15. Eye (Lond). 2015 Jul 31. doi: 10.1038/eye.2015.143. [Epub ahead of print]

Certification figures and their accuracy.

Quartilho A(1), Zekite A(1), Xing W(1), Loutfi M(2), Bunce C(3), Wormald R(3).

Author information: 
(1)Department of Research & Development, NIHR BRC for Ophthalmology at Moorfields
Eye Hospital and UCL Institute of Ophthalmology, London, UK. (2)School of
Medicine, University of Liverpool, Liverpool, UK. (3)1] Department of Research & 
Development, NIHR BRC for Ophthalmology at Moorfields Eye Hospital and UCL
Institute of Ophthalmology, London, UK [2] London School of Hygiene & Tropical
Medicine, London, UK.

PMID: 26228289   [PubMed - as supplied by publisher]


16. Eye (Lond). 2015 Jul 31. doi: 10.1038/eye.2015.140. [Epub ahead of print]

The stereotypical molecular cascade in neovascular age-related macular
degeneration: the role of dynamic reciprocity.

Kent D(1).

Author information: 
(1)1] The Vision Clinic, Kilkenny, Ireland [2] Faculty of Health and Life
Sciences, Institute of Ageing and Chronic Disease, University of Liverpool,
Liverpool, UK.

This review summarises our current understanding of the molecular basis of
subretinal neovascularisation (SRNV) in age-related macular degeneration (AMD).
The term neovascular AMD (NVAMD) is derived from the dominant early clinical
features of haemorrhage, fluid, and lipid in the subretinal space (SRS) and the
historical role of fluorescein angiography in detecting the presence of NV
tissue. However, at the cellular level, SRNV resembles an aberrant but
stereotypical tissue repair response that incorporates both an early inflammatory
phase and a late fibrotic phase in addition to the neovascular (NV) component
that dominates the early clinical presentation. This review will seek not only to
highlight the important molecules involved in each of these components but to
demonstrate that the development of SRNV has its origins in the earliest events
in non-NV AMD pathogenesis. Current evidence suggests that this early-stage
pathogenesis is characterised by complement-mediated immune dysregulation,
leading to a state of chronic inflammation in the retinal pigment
epithelium/Bruch's membrane/choriocapillaris complex. These initial events can be
seamlessly and inextricably linked to late-stage development of SRNV in AMD by
the process of dynamic reciprocity (DyR), the ongoing bidirectional communication
between cells, and their surrounding matrix. Moreover, this correlation between
disease onset and eventual outcome is reflected in the temporal and spatial
correlation between chronic inflammation, NV, and fibrosis within the reparative 
microenvironment of the SRS. In summary, the downstream consequences of the
earliest dysfunctional molecular events in AMD can result in the late-stage
entity we recognize clinically as SRNV and is characterized by a spectrum of
predictable, related, and stereotypical processes referred to as DyR.Eye advance 
online publication, 31 July 2015; doi:10.1038/eye.2015.140.

PMID: 26228288   [PubMed - as supplied by publisher]