1: Eye (Lond). 2012 Jan 27; [Epub ahead of print] 

Acute retinal necrosis in the United Kingdom: results of a prospective
surveillance study.

Cochrane TF, Silvestri G, McDowell C, Foot B, McAvoy CE.

Ophthalmology Department, Royal Victoria Hospital, Belfast Health and Social
Care Trust, Belfast, UK.

BackgroundTo determine the incidence of acute retinal necrosis (ARN) in the
United Kingdom and to describe the demographics, management, and visual outcome
in these patients.MethodsThis was a prospective study carried out by the British
Ophthalmological Surveillance Unit (BOSU) between September 2007 and October
2008. Initial and 6-month questionnaires were sent to UK ophthalmologists who
reported cases of ARN via the monthly BOSU report card system.ResultsIn all, 45
confirmed cases (52 eyes) of ARN were reported in the 14-month study period,
giving a minimum incidence of 0.63 cases per million population per year. There
were 20 females and 25 males. Age ranged from 10 to 94 years. Eight patients had
a history of herpetic CNS disease. Aqueous sampling was carried out in 13
patients, vitreous in 27, and cerebrospinal fluid (CSF) in 4. Varicella-zoster
virus followed by herpes simplex were the most common causative agents.
Treatment in 76% of the cases was with intravenous antivirals; however, 24%
received only oral antivirals. In all, 47% of patients had intravitreal
antiviral therapy. Visual outcome at 6 months was <6/60 in 48% of the affected
eyes.ConclusionThe minimum incidence of ARN in the UK is 0.63 cases per million.
Patients with a history of herpetic CNS disease should be warned to immediately
report any visual symptoms. There is increased use of oral and intravitreal
antivirals in initial treatment.Eye advance online publication, 27 January 2012;
doi:10.1038/eye.2011.338.

PMID: 22281865  [PubMed - as supplied by publisher]

2: Eye (Lond). 2012 Jan 27; [Epub ahead of print] 

A new, pachymetry-based approach for diagnostic cutoffs for normal, suspect and
keratoconic cornea.

Prakash G, Agarwal A, Mazhari AI, Kumar G, Desai P, Kumar DA, Jacob S, Agarwal
A.

Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.

PurposeTo analyze whether an association exists between keratometric and
pachymetric changes in the cornea, and whether it can be used to create
pachymetric cutoff criteria secondary to keratometric criteria.MethodsIn this
cross-sectional study, 1000 candidates presenting to the refractive surgery
services of a tertiary care hospital underwent bilateral Orbscan IIz (Bausch and
Lomb) assessment along with other ophthalmic evaluation.ResultsStepwise
regression analysis-based models showed that simulated keratometry (simK)
astigmatism was significantly predicted by the minimum corneal thickness (MCT)
and difference between central and MCT (deltaCT), mean SimK by the MCT and
deltaCT, and maximum keratometry in the central 10-mm zone by the MCT and
deltaCT (P<0.001). The mean MCT values were 542.5+/-39.6, 539.9+/-39.2,
524.2+/-49.5, and 449.3+/-73.7 mum for flatter normal (<44 D), steeper normal
(>/=44 D), keratoconus suspect and keratoconic eyes, respectively (P<0.001). The
mean differences between central corneal thickness and MCT (deltaCT) were
12.2+/-7.1 mum, 12.4+/-7.4 mum, 14.4+/-8.9 mum and 23.2+/-10.1 mum for the
flatter normal, steeper normal, keratoconus suspect, and keratoconic eyes,
respectively (P<0.001). Mean and 2SD cutoff were used to suggest that a cornea
having MCT<461 mum or deltaCT>27 mum has only a 2.5% chance of being normal and
not a keratoconus suspect or worse.ConclusionPachymetric diagnostic cutoffs can
be used as adjuncts to the existing topographic criteria to screen keratoconus
suspect and keratoconic eyes.Eye advance online publication, 27 January 2012;
doi:10.1038/eye.2011.365.

PMID: 22281864  [PubMed - as supplied by publisher]

3: Eye (Lond). 2012 Jan 20; [Epub ahead of print] 

The effect of orbital decompression surgery on refraction and intraocular
pressure in patients with thyroid orbitopathy.

Norris JH, Ross JJ, Kazim M, Selva D, Malhotra R.

Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, UK.

PurposeTo investigate the effect of orbital decompression surgery in thyroid
orbitopathy (TO) on both refractive status and intraocular pressure
(IOP).Patients and methodsA prospective, multicentre, consecutive audit of
patients undergoing thyroid decompression surgery. Indications for surgery
included cosmetically unacceptable proptosis or corneal exposure. Exclusion
criteria included the following: previous orbital surgery, glaucoma, corneal
disease, steroid use in the preceding 12 months, or an acute optic neuropathy.
Automated refraction, keratometry, pachymetry, Hertel exophthalmometry, and IOP
were recorded at 1 month pre- and 3 months postoperatively. IOP using the
Tono-Pen (mean of three readings) was measured in the primary, upgaze, and
downgaze positions.ResultsData were collected from 52 orbits of 33 patients
(East Grinstead, New York, and Adelaide). There was no significant difference
between pre- and postoperative data for sphere, cylinder, or central corneal
thickness (CCT). The mean spherical equivalent was -0.43+/-1.49 D
pre-operatively and -0.28+/-1.52 D postoperatively. The steepest meridian of
corneal curvature was 93.1 degrees pre- and 94.2 degrees postoperatively, with
no significant difference. Mean IOP significantly decreased when measuring by
Goldmann applanation tonometry (GAT) (2.28 mm Hg, (*) P=0.001) and Tono-Pen
(3.06 mm Hg, (*) P=<0.0001). IOP measured in upgaze was significantly greater
than that in the primary position. Regression analysis between change in IOP and
either Hertel exophthalmometry or the number of orbital walls decompressed was
non-significant ((*)Student's t-test).ConclusionPatients with TO undergoing
orbital decompression had, on average, with-the-rule astigmatism not affected by
orbital decompression surgery. IOP was significantly reduced by decompression
surgery although no relationship between IOP and the degree of decompression was
observed.Eye advance online publication, 20 January 2012;
doi:10.1038/eye.2011.362.

PMID: 22261739  [PubMed - as supplied by publisher]

4: Eye (Lond). 2012 Jan 20; [Epub ahead of print] 

Angioid streaks with severe macular dysfunction and generalised retinal
involvement due to a homozygous duplication in the ABCC6 gene.

Tan MH, Vanakker OM, Tran HV, Robson AG, Lai-Cheong JE, Groves R, Holder GE,
Moore AT.

1] University College London (UCL) Institute of Ophthalmology, London, UK [2]
Moorfields Eye Hospital, London, UK.

PMID: 22261738  [PubMed - as supplied by publisher]

5: Eye (Lond). 2012 Jan 20; [Epub ahead of print] 

Cost analysis comparing adjuvant epimacular brachytherapy with anti-VEGF
monotherapy for the management of neovascular age-related macular degeneration.

Jackson TL, Kirkpatrick L, Tang G, Prasad S.

1] School of Medicine, King's College, London, UK [2] Department of
Ophthalmology, King's College Hospital, London, UK.

AimsTo consider the cost implication of adopting epimacular brachytherapy (EMB)
for the treatment of neovascular (wet) age-related macular degeneration (wAMD),
compared with ranibizumab or bevacizumab monotherapy.MethodsThis analysis
compared the cumulative 3-year costs of anti-VEGF (vascular endothelial growth
factor) monotherapy to EMB combined with anti-VEGF therapy. Two patient groups
were considered: newly diagnosed (treatment-naive) patients; and patients
already receiving chronic anti-VEGF therapy.ResultsIn the treatment-naive
patients, the highest cumulative treatment costs were associated with
ranibizumab monotherapy ( pound25 658), followed by bevacizumab monotherapy (
pound16 177), EMB with ranibizumab ( pound14 002), then EMB with bevacizumab (
pound10 289). In previously treated patients, the highest treatment costs were
ranibizumab monotherapy ( pound18 355), followed by EMB with ranibizumab (
pound17 428), bevacizumab monotherapy ( pound16 177), then EMB with bevacizumab
( pound12 129).ConclusionEMB combined with anti-VEGF treatment has the potential
to yield considerable cost savings, compared with anti-VEGF monotherapy. If the
ongoing large studies of EMB confirm the published feasibility data, then
adjuvant EMB may represent a cost-effective alternative to anti-VEGF
monotherapy.Eye advance online publication, 20 January 2012;
doi:10.1038/eye.2011.351.

PMID: 22261737  [PubMed - as supplied by publisher]

6: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Viral causes of unexplained anterior uveitis in Thailand.

Kongyai N, Sirirungsi W, Pathanapitoon K, Tananuvat N, Kunavisarut P,
Leechanachai P, de Groot-Mijnes JD, Rothova A.

Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang
Mai University, Chiang Mai, Thailand.

AimsTo assess the possible role of virus infection in patients with unexplained
anterior uveitis (AU).MethodsIntraocular fluid and plasma samples of 30
HIV-negative AU patients who were unresponsive or poorly responsive to topical
steroid therapy were analyzed for nucleic acid of cytomegalovirus (CMV), herpes
simplex virus (HSV), and varicella zoster virus (VZV) by real-time polymerase
chain reaction (PCR) and for intraocular antibodies against these viruses by
Goldmann-Witmer coefficient (GWC) analysis. Of these 30 cases, 21 were tested
for rubella virus by GWC analysis, 16 of which also had PCR assessment of
aqueous for rubella virus.ResultsViral uveitis determined by either real-time
PCR and/or GWC was documented in 20 out of 30 patients (67%). Of 30 paired
samples tested by both methods for HSV, CMV, and VZV, 15 showed positive results
(CMV (10), HSV (4), and VZV (1)). Real-time PCR was positive in 8/15 (53%),
whereas GWC was positive in 10/15 (67%). Out of 10 CMV-positive patients, four
had endotheliitis, two had Posner-Schlossman syndrome, and one Fuchs
heterochromic uveitis syndrome (FHUS). Five out of 21 (24%) samples tested by
GWC for Rubella virus were positive, three of which exhibited clinical features
of FHUS.ConclusionsOur results indicate that CMV is a major cause of AU in
Thailand and show that FHUS can be caused by both CMV and Rubella virus.Eye
advance online publication, 13 January 2012; doi:10.1038/eye.2011.363.

PMID: 22241022  [PubMed - as supplied by publisher]

7: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Retrobulbar hemodynamic parameters in open-angle and angle-closure glaucoma
patients.

Marjanovic I, Milic N, Martinez A, Benitez-Del-Castillo J.

Glaucoma Department, University Eye Clinic, Clinical Centre of Serbia, Belgrade,
Serbia.

PurposeThe purpose of this study is to compare the retrobulbar hemodynamic
parameters in the ophthalmic artery (OA), central retinal artery (CRA), and
posterior cilliary arteries (PCA), in open-angle glaucoma (OAG) and
angle-closure glaucoma (ACG) patients.Patients and methodsA total of 52 eyes
from 52 patients with OAG and 25 eyes from 25 ACG patients who met the
inclusion/exclusion criteria were included in this cross-sectional study.
Peak-systolic velocity, end-diastolic velocity, and Pourcelot resistivity index
(RI) were assessed in the OA, CRA, and PCA. Intraocular pressure (IOP) was
measured both with the Goldmann applanation tonometer (GAT) and with the Dynamic
Contour tonometer (DCT) three times, respectively. Ocular pulse amplitude was
measured using DCT.ResultsThe RI was significantly higher in both the ophthalmic
and short PCA in the OAG patients as compared with that in those ACG patients,
P=0.003 and 0.048, respectively. There was no correlation between the IOP
measured with GAT and the retrobulbar hemodynamic parameters in either OAG or
ACG.ConclusionsThere was an increased resistance to blood flow in the OA of OAG
as compared with ACG patients. Additionally, the degree of circulatory
disturbance was not related to either the IOP or the visual-field damage.Eye
advance online publication, 13 January 2012; doi:10.1038/eye.2011.364.

PMID: 22241021  [PubMed - as supplied by publisher]

8: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Surgical and visual outcome following 20-gauge vitrectomy in proliferative
diabetic retinopathy over a 10-year period, evidence for change in practice.

Gupta B, Wong R, Sivaprasad S, Williamson TH.

St Thomas' Hospital, London, UK.

IntroductionThe study reports 10-year anatomical and visual outcome in patients
who underwent pars plana vitrectomy (PPV) for complications due to proliferative
diabetic retinopathy (PDR).MethodsRetrospective analysis of patients undergoing
20G PPV from January 1999 to May 2010 for tractional retinal detachment (TRD)
and non-clearing vitreous hemorrhage (NCVH) secondary to PDR recorded
prospectively on an electronic patient record. The primary aim was to study
anatomical success and eyes with visual acuity (VA) of /=1.0 (Snellen 6/60). In all, 50/181
(27.6%) eyes with TRD and 84/165 (50.9%) with NCVH achieved final VA of /=0.3 logMAR improvement
from baseline to last follow-up. Both preoperative VA and final postoperative
(post-op) VA (P<0.001) improved significantly with each year from 1999 to 2010.
The commonest peroperative complication was iatrogenic retinal tear formation
(28.4%). This was a risk factor for the development of post-op retinal
detachment, odds ratio: 3.90 (95% confidence interval: 1.91-7.97, P=0.0002).
Silicone oil was used in 5.2% of patients at the primary procedure. In all, 9.2%
required removal of non clearing post vitrectomy hemorrhage.ConclusionsOutcomes
from vitreoretinal surgery for complications of diabetic retinopathy have
improved. In addition, the visual outcome after diabetic vitrectomy steadily
improved over the 10-year period, which may in part be due to the move to
operate on patients with better vision.Eye advance online publication, 13
January 2012; doi:10.1038/eye.2011.348.

PMID: 22241020  [PubMed - as supplied by publisher]

9: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Assessing Graves' ophthalmopathy-specific quality of life in Korean patients.

Choi YJ, Lim HT, Lee SJ, Lee SY, Yoon JS.

Institute of Vision Research, Department of Ophthalmology, Yonsei University
College of Medicine, Seoul, South Korea.

AimTo investigate the clinical significance of Grave's ophthalmopathy-specific
quality of life (GO-QOL) in Korean patients.MethodsA cross-sectional study was
conducted at the Department of Ophthalmology, Yonsei University College of
Medicine, Seoul, Korea, on 98 consecutive Grave's ophthalmopathy (GO) patients.
The GO-QOL survey provided by Terwee and colleagues and suggested by the
European group on Graves' orbitopathy (EUGOGO) was translated into Korean
language and distributed to study participants. Clinical severity was judged by
scores of the modified NOSPECS classification, and inflammatory activity was
measured by a seven-point scale of clinical activity score (CAS).ResultsThe mean
GO-QOL scores were 73.7 (standard deviation (SD), 26) for visual functioning,
61.9 (SD 26) for appearance, and 67.8 for total quality of life (QOL; SD 22).
The worse QOL scores for each part were significantly associated with the higher
modified NOSPECS score and CAS after adjusting for confounders such as age and
sex (P<0.05, respectively). In particular, decreased QOL scores for visual
function were significantly correlated with a higher grade of extraocular muscle
involvement (P<0.05). Lower QOL scores for appearance were associated with more
severe soft-tissue involvement and proptosis (P<0.05,
respectively).ConclusionsGO-QOL suggested by EUGOGO showed correlation with
objective clinical parameters. GO-QOL can be a simple and effective tool in the
evaluation of the clinical and psychological illness of GO patients.Eye advance
online publication, 13 January 2012; doi:10.1038/eye.2011.359.

PMID: 22241019  [PubMed - as supplied by publisher]

10: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Discoid lupus erythematosus of the periorbita: clinical dilemmas, diagnostic
delays.

Gupta T, Beaconsfield M, Rose GE, Verity DH.

Adnexal Department, Moorfields Eye Hospital, London, UK.

PurposeUntreated periocular discoid lupus erythematosus (DLE), though very rare,
may lead to significant morbidity with lid deformities, trichiasis, and
symblepharon formation. We present the largest reported cohort of patients with
biopsy-proven DLE solely affecting the periorbital region.MethodsObservational
case series of patients managed over a 7-year period (2004-10).ResultsSeven
patients (one male) presented to the Adnexal Service at Moorfields Eye Hospital
at a median age of 47 years (range 23-71 years); median interval from symptom
onset to biopsy-proven diagnosis was 38 months (range 6-86 months). Changes in
peripheral skin were present in 1 patient (occurring after the initial eyelid
presentation) and the presenting periocular features were dissimilar across the
group, these included: chronic blepharo-conjunctivitis, madarosis, atypical
chalazia, depigmentation of the eyelid margin, or marked, persistent periocular
oedema with dacryoadenitis.Two cases settled spontaneously, but five required
systemic hydroxychloroquine or intralesional corticosteroid
injections.ConclusionPeriorbital DLE is rare and very varied in its
presentation, the protean manifestations often resulting in significant
diagnostic delay. All patients with unusual periocular skin disease and those
with a refractory inflammatory dermopathy, should undergo biopsy of involved
tissue(s), thus leading to earlier diagnosis and prevention of permanent
cicatricial periocular changes.Eye advance online publication, 13 January 2012;
doi:10.1038/eye.2011.340.

PMID: 22241018  [PubMed - as supplied by publisher]

11: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Visual outcome in Japanese patients with Acanthamoeba keratitis.

Yamazoe K, Yamamoto Y, Shimazaki-Den S, Shimazaki J.

1] Department of Ophthalmology, Tokyo Dental College, Chiba, Japan [2]
Department of Ophthalmology, Kameda Medical Center, Chiba, Japan.

PurposeTo identify prognostic factors affecting visual outcome in Acanthamoeba
keratitis (AK) treated with topical chlorhexidine gluconate (CHG).MethodsA total
of 35 eyes in 34 patients with AK were treated with 0.02% topical CHG. Patients
were divided into two groups according to the final visual outcome: Group 1,
final visual acuity (VA) of 20/25 or greater (22 eyes); Group 2, less than 20/25
(13 eyes). We compared these groups and evaluated the effectiveness of topical
CHG compared with outcomes in previous reports.ResultsRing infiltrate was
observed more often in Group 2 (4.5% vs 61.5%, OR 33.6, 95% confidence interval
(CI) 3.4-333.9, P<0.01). The duration between onset and diagnosis of AK was
significantly longer (24.9 days vs 48.4 days, OR 1.03, 95% CI 1.00-1.06, P=0.04)
and VA at initial examination (log MAR) significantly lower (0.47 vs 1.59, OR
25.5, 95% CI 3.4-186.7, P<0.01) in Group 2 (visual outcome <20/25). Multivariate
analysis revealed that only VA at initial examination was independently
associated with worse visual outcome (adjusted OR 24.5, 95% CI 1.9-312.6,
P=0.01). Seventeen (85.0%) of the 20 eyes diagnosed within 1 month and 24
(82.8%) of 29 eyes diagnosed within 2 months achieved a VA of 20/40 or
greater.ConclusionVA at initial examination was the most predictive factors for
final visual outcome in AK. Topical CHG was comparably effective to other
treatments, including polyhexamethyl biguanide and propamidine isethionate.Eye
advance online publication, 13 January 2012; doi:10.1038/eye.2011.366.

PMID: 22241017  [PubMed - as supplied by publisher]

12: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Combined OCT and colour fundus photography in virtual clinic assessments of wet
AMD patients.

Mookhtiar M, Downey L.

St James University Teaching Hospital, Department of Ophthalmology, Leeds
Teaching Hospitals NHS Trust, Leeds, UK.

PMID: 22241016  [PubMed - as supplied by publisher]

13: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Idiopathic macular hole in a child.

Park JC, Frimpong-Ansah KN.

Plymouth Royal Eye Infirmary, Plymouth, Devon, UK.

PMID: 22241015  [PubMed - as supplied by publisher]

14: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

New approaches for the treatment of diabetic macular oedema: recommendations by
an expert panel.

Bandello F, Cunha-Vaz J, Chong NV, Lang GE, Massin P, Mitchell P, Porta M,
Prunte C, Schlingemann R, Schmidt-Erfurth U.

Department of Ophthalmology, University Vita-Salute, Scientific Institute San
Raffaele, Milano, Italy.

The current standard therapy for patients with diabetic macular oedema
(DME)-focal/grid laser photocoagulation-usually does not improve impaired
vision, and many patients lose vision despite laser therapy. Recent approval of
ranibizumab by the European Medicines Agency to treat visual impairment due to
DME fulfils the previously unmet medical need for a treatment that can improve
visual acuity (VA) in these patients. We reviewed 1- and 2-year clinical trial
findings for ranibizumab used as treatment for DME to formulate evidence-based
treatment recommendations in the context of this new therapy. DME with or
without visual impairment should be considered for treatment when it fulfils the
Early Treatment Diabetic Retinopathy Study (ETDRS) criteria for clinically
significant oedema. For DME with centre involvement and associated vision loss
due to DME, monthly ranibizumab monotherapy with treatment interruption and
re-initiation based on VA stability is recommended. Laser therapy based on ETDRS
guidelines is recommended for other forms of clinically significant DME without
centre involvement or when no vision loss has occurred, despite centre
involvement. Because these recommendations are based on randomised controlled
trials of 1-2 years duration, guidance may need updating as long-term
ranibizumab data become available and as additional therapeutic agents are
assessed in clinical trials.Eye advance online publication, 13 January 2012;
doi:10.1038/eye.2011.337.

PMID: 22241014  [PubMed - as supplied by publisher]

15: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Response to 'Combined OCT and colour fundus photography in virtual clinic
assessments of wet AMD patients'

Hibbs SP, Smith A, Chow LP, Downes SM.

The Oxford Eye Hospital, John Radcliffe Hospital, Oxford, UK.

PMID: 22241013  [PubMed - as supplied by publisher]

16: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

Retinal detachment associated with optic disc colobomas and morning glory
syndrome.

Chang S, Gregory-Roberts E, Chen R.

Edward S. Harkness Eye Institute, Columbia University Medical Center, Department
of Ophthalmology, New York, NY, USA.

We report the diagnosis and treatment of patients with retinal detachment and/or
retinoschisis associated with optic nerve coloboma or morning glory syndrome. A
retrospective review of patients with optic nerve coloboma or morning glory
syndrome with associated retinal detachment or retinoschisis was conducted. For
five patients (six eyes), we report the clinical findings, spectral domain
optical coherence tomography (OCT) imaging, intraoperative findings, and
treatment outcomes. OCT scans demonstrate a bilaminar structure of maculopathy,
consisting of inner schisis-like changes and outer layer retinal detachment. In
most cases, a retinal break was demonstrated within the optic disc defect with
three-dimensional OCT imaging. Glial tissue was sometimes observed within the
anomalous defect. Vitrectomy and resection of the tractional tissue in these
cases produced good anatomical and visual outcomes. Retinal detachment
spontaneously resolved in cases where traction was not present. Traction may
contribute to the pathogenesis of retinal detachment associated with
colobomatous optic disc anomalies, either directly or by creating a secondary
retinal break. OCT imaging assists with understanding the contributing factors
to retinal detachment in individual cases of colobomatous optic disc anomalies
and can thereby assist with determining the most effective approach to
management.Eye advance online publication, 13 January 2012;
doi:10.1038/eye.2011.354.

PMID: 22241012  [PubMed - as supplied by publisher]

17: Eye (Lond). 2012 Jan 13; [Epub ahead of print] 

A comparison of intrascleral bleb height by anterior segment OCT using three
different implants in deep sclerectomy.

Fernandez-Buenaga R, Rebolleda G, Casas-Llera P, Munoz-Negrete FJ, Perez-Lopez
M.

1] Hospital Ramon y Cajal, Madrid, Spain [2] Vissum Corporation-Instituto
Oftalmologico de Alicante, Alicante, Spain.

PurposeTo compare intrascleral blebs characteristics after deep sclerectomy (DS)
with three intrascleral implants using the Visante anterior segment optical
coherence tomography.MethodsThis is a cross-sectional study including 60 eyes of
51 patients that underwent DS with Sk-Gel, Esnoper, and Aquaflow implant.
Intraocular pressure (IOP) measurement, slit-lamp examination, and Visante scans
were performed the same day in all the patients. Visante scans were done through
the intrascleral bleb at 45 degrees , 90 degrees , and 135 degrees  and the bleb
height was measured.ResultsSk-Gel was used in 19 eyes (31.66%), Esnoper in 22
eyes (36.66%), and Aquaflow in 19 eyes (31.66%). The median time lapsed from the
surgery was 15.50 months 25th and 75th percentiles (p(25) 8.25; p(75) 20). The
median IOP was 13 mm Hg (p(25) 10; p(75) 15), with no significant differences
among implants (P=0.232). Overall, the correlation between the scleral bleb
height and the IOP was statistically significant at 45 degrees  (r=-0.359;
P=0.004), 90 degrees  (r=-0.410; P=0.001), and 135 degrees  (r=-0.417; P=0.001).
However, Sk-Gel did not show any statistically significant correlation between
the scleral height and IOP whereas the other two groups (Esnoper and Aquaflow)
showed a significant correlation. There were no differences in the bleb height
among implants.ConclusionThere was a moderate inverse correlation between the
scleral bleb height and the IOP measurement after DS with Esnoper and Aquaflow
implants. There were no differences in bleb height among the three implants.Eye
advance online publication, 13 January 2012; doi:10.1038/eye.2011.358.

PMID: 22241011  [PubMed - as supplied by publisher]

18: Eye (Lond). 2012 Jan;26(1):175. 

Measurement of intraocular pressure in children in the UK.

Chan WH, Lloyd IC, Ashworth JL, May K, Bhojwani RD, Biswas S.

PMID: 22237389  [PubMed - in process]

19: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Visual and anatomical outcomes following vitrectomy for complications of
diabetic retinopathy: The DRIVE UK Study.

Gupta B, Sivaprasad S, Wong R, Laidlaw A, Jackson TL, McHugh D, Williamson TH.

Laser and Retinal Research Unit, Department of Opthalmology, King's College
Hospital, London, UK.

IntroductionEnd-stage diabetic eye disease is an important cause of severe
visual impairment in the working-age group. With the increasing availability of
refined surgical techniques as well as the early diagnosis of disease because of
screening, one would predict that the prevalence of this condition is decreasing
and the visual outcome is improving.AimTo study the prevalence and visual
outcome following vitrectomy for complications of diabetic retinopathy.Materials
and methodsThis study identified the patients who underwent vitrectomy from
January 2007 to December 2009 because of diabetes-related complications in South
East London. Data collected included baseline demographics, best-corrected
visual acuity, indication for the vitrectomy, complication, outcome, and
duration of follow-up.ResultsThe prevalence of people requiring vitrectomy who
are registered in the diabetes register of this region was 2 per 1000 people
with diabetes. Vitrectomy was required in 185 eyes of 158 patients during this
period. These included 83 Caucasians, 51 Afro-Caribbeans, 17 South Asians, and 7
from other ethnic groups. There were 58 patients with type I diabetes and 100
with type II, with a mean duration of diabetes of 23 and 16.5 years,
respectively. The reason for vitrectomy included tractional retinal detachment
(TRD) in 109 eyes, non-clearing vitreous haemorrhage (NCVH) in 68 eyes, and
other causes in 8 eyes. In all, 50% of the eyes with TRD and NCVH, and 87% of
the eyes with NCVH improved by at least three ETDRS lines at 12 months. Poor
predictors of visual success included longer duration of diabetes (OR: 0.69),
use of insulin (OR: 0.04), presence of ischaemic heart disease (OR: 0.04), delay
in surgery (OR: 0.59), and the failure to attend clinic appointments (OR: 0.58).
Preoperative use of intravitreal bevacizumab in eyes with TRD undergoing
vitrectomy showed a marginal beneficial effect on co-existent maculopathy
(P=0.08) and required less laser intervention post procedure, but did not affect
the number of episodes of late-onset vitreous haemorrhage post vitrectomy
(P=0.81).ConclusionVisual outcome has improved significantly in eyes with
complications due to diabetic retinopathy compared with the previously reported
Diabetic Vitrectomy Study.Eye advance online publication, 6 January 2012;
doi:10.1038/eye.2011.321.

PMID: 22222268  [PubMed - as supplied by publisher]

20: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Distribution, reabsorption, and complications of preretinal blood under silicone
oil after vitrectomy for severe proliferative diabetic retinopathy.

Yeh PT, Yang CM, Yang CH.

Department of Ophthalmology, National Taiwan University Hospital, and Medical
College, National Taiwan University, Taipei, Taiwan.

PurposeTo examine the evolution and complications of preretinal hemorrhage under
silicone oil after diabetic vitrectomy.MethodsA total of 44 cases of primary
diabetic vitrectomy with silicone oil infusion were reviewed in a 3-year period.
Intravitreal bevacizumab was used preoperatively for cases with active
proliferation, and in all cases at the end of surgery. Intraoperative bleeding,
postoperative extent of preretinal hemorrhage, blood reabsorption time, and
reproliferation and treatment results were assessed.ResultsMaximal blood
distributed in thin and scattered patterns (23 cases), thick and localized
patterns (10 cases), or thick and scattered patterns (10 cases) developed within
1 week after surgery, and was largely reabsorbed within a month with improved
postoperative vision. Confluent blood extending to the midperiphery (one case)
resulted in severe fibrosis and detachment. Complications included fibrotic
plaque (two cases), and fibrous band and thick membrane (seven cases). Six cases
underwent preretinal tissue removal. Vision improvement>/=3 lines was noted in
three cases.ConclusionMost of the rebleeding occurred within the first post-op
week, with gradual reabsorption in the posterior pole within 4 weeks; widespread
confluent bleeding might result in severe reproliferation and detachment. A
major complication of preretinal bleeding was the formation of preretinal
fibrosis. Re-operation achieved a mild VA improvement.Eye advance online
publication, 6 January 2012; doi:10.1038/eye.2011.318.

PMID: 22222267  [PubMed - as supplied by publisher]

21: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Response to: Comment on 'Phakic intraocular lenses outcomes and complications:
Artisan vs Visian ICL'

Macky TA, Hasaballa MA.

Department of Ophthalmology, Cairo University Hospitals, Cairo, Egypt.

PMID: 22222266  [PubMed - as supplied by publisher]

22: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Toxoplasmosis: new challenges for an old disease.

Bodaghi B, Touitou V, Fardeau C, Paris L, Lehoang P.

Department of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France.

More than a century after the identification of Toxoplasma gondii, major issues
need to be addressed for the optimal management of ocular disease. Toxoplasmic
retinochoroiditis is the main cause of posterior uveitis in several geographical
areas. The parasite establishes a love-hate relationship with the eye,
manipulating the immune response and inducing variable initial lesions and
further relapses. It is now well established that most cases are acquired after
birth and not congenital. The severity of the disease is mainly due to the
parasite genotype and the host immune status. Diagnosis is based on clinical
features, but may be confirmed by biological tools applied to ocular fluids.
Combining several techniques improves the diagnostic yield in equivocal cases.
Therapeutic management is the most important challenge. Even though
evidence-based data on the efficacy of anti-parasitic drugs are still missing,
new strategies with a good safety profile are available and may be proposed
earlier during the course of the disease, but also in selected cases, to reduce
sight-threatening relapses. Revisiting the therapeutic options and indications
may be an important step towards long-term maintenance of the visual function
and avoidance of major complications.Eye advance online publication, 6 January
2012; doi:10.1038/eye.2011.331.

PMID: 22222265  [PubMed - as supplied by publisher]

23: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Adalimumab specifically induces CD3(+) CD4(+) CD25(high) Foxp3(+) CD127(-)
T-regulatory cells and decreases vascular endothelial growth factor plasma
levels in refractory immuno-mediated uveitis: a non-randomized pilot
intervention study.

Calleja S, Cordero-Coma M, Rodriguez E, Llorente M, Franco M, Ruiz de Morales
JG.

Department of Clinical Immunology, Complejo Hospitalario Universitario de Leon,
Leon, Spain.

AimTo explore immunoregulatory and anti-inflammatory pathways specifically
targeted by a subcutaneous anti-TNFalphadrug-adalimumab-which might be relevant
for controlling refractory uveitis.DesignNon-randomized pilot intervention study
on the effects of adalimumab on Treg populations and plasma VEGF levels in
refractory uveitis patients. Inflammatory and immunological parameters were
measured in 12 patients before therapy, and 1 and 6 months after therapy, and
analyzed in the context of ophthalmological outcomes. The results were compared
with those obtained in 10 systemic prednisone-treated uveitis
patients.ResultsAfter 1 month of treatment, all patients responded, with 67% of
adalimumab group and 80% of the corticosteroid group achieving inactivity
(P=0.5). Unlike steroid-treated patients, a significant increase in T-regulatory
CD4(+) CD25(high) Foxp3(+) CD127(-) cells was observed in adalimumab patients
after 1 month of treatment, and maintained after 6 months (P=0.003). A
significant adalimumab-specific drop in plasma VEGF was observed after 1 and 6
months of treatment (P=0.019). In every single patient, Tregs but not VEGF
correlated with disease activity.ConclusionsIn refractory uveitis patients
treated with adalimumab, clinical efficacy may be mediated through upregulation
of Tregs in addition to modulation of VEGF-mediated inflammatory pathways. These
biological properties, which were not observed in patients treated with
corticosteroids, may reflect the specificity of TNF-alphatargeting.Eye advance
online publication, 6 January 2012; doi:10.1038/eye.2011.320.

PMID: 22222264  [PubMed - as supplied by publisher]

24: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Shared care of patients with ocular hypertension in the Community and Hospital
Allied Network Glaucoma Evaluation Scheme (CHANGES).

Mandalos A, Bourne R, French K, Newsom W, Chang L.

Glaucoma Service, Department of Ophthalmology, Hinchingbrooke Hospital,
Huntingdon, Cambridgeshire, UK.

AimsThe Community and Hospital Allied Network Glaucoma Evaluation Scheme
(CHANGES) used accredited community-based optometrists with a special interest
(OSIs) in glaucoma to monitor ocular hypertensive (OHT) patients under virtual
supervision of the Hospital Glaucoma Service (HGS). The purpose of this paper
was to report the outcomes of the first completed community-based
visit.MethodsEligible patients underwent a glaucoma consultant-led clinical
examination before transfer to CHANGES. Individualised intraocular pressure
(IOP) and follow-up time interval targets were set for each patient. OSIs used
applanation tonometry, slit-lamp biomicroscopy, automated visual field testing
and digital optic disc photography. The hospital-based glaucoma team evaluated
the data virtually. Patients were referred back to the HGS according to specific
criteria.ResultsOne hundred and sixty eight OHT patients were invited to attend
their first OSI appointment. Of these, 144 attended their appointment
(attendance rate 85.7%). Outcomes of 130 patients with complete data sets are
reported. Sixteen patients (12.3%) were referred back to the HGS due to IOP
above target, new visual field defects and/or optic nerve changes. The glaucoma
consultant retained eight patients (6.1%) within the HGS on the basis of
definite or probable glaucomatous conversion.ConclusionsCHANGES freed up
capacity within a busy HGS. However, improvements need to be made regarding
non-attendance rates in the community. The relatively high one-year definite or
probable conversion rate emphasises the importance of the comprehensive review
of OHT patients and of hospital-led virtual supervision to maintain patient
safety.Eye advance online publication, 6 January 2012; doi:10.1038/eye.2011.350.

PMID: 22222263  [PubMed - as supplied by publisher]

25: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Association between various types of obesity and macular pigment optical
density.

Gupta A, Raman R, Biswas S, Rajan R, Kulothungan V, Sharma T.

Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India.

PurposeTo elucidate the association between macular pigment optical density
(MPOD) and various types of obesity in the South-Indian population.Patients and
methodsIn total, 300 eyes of 161 healthy volunteers of South-Indian origin were
studied. MPOD was measured psychophysically at 0.25 degrees , 0.50 degrees ,
1.00 degrees , and 1.75 degrees  eccentricities from fovea. Anthropometric
measurements included waist circumference (WC) and waist-to-hip ratio (WHR) and
body mass index (BMI). Using the WHO Expert Consultation guidelines, obesity was
defined based on BMI alone (BMI>/=23 kg/m(2)), based on WC alone (WC>/=90 cm for
men and >/=80 cm for women), and based on WHR alone (>/=0.90 for men and >/=0.85
for women). Isolated generalized obesity was defined as increased BMI and normal
WC. Isolated abdominal obesity was defined as increased WC and normal BMI.
Combined obesity was defined as increased BMI and increased WC.ResultsMean MPOD
at all eccentricities was not significantly different between men and women.
Mean MPOD values did not significantly differ in various types of obesity, when
compared with the normal subjects. On subgroup analysis, in age group >/=60
years, mean MPOD values were significantly higher in subjects with obesity based
on BMI (0.61 vs0.41, P=0.036), obesity based on WHR (0.67 vs0.41, P=0.007), and
isolated generalized obesity (0.66 vs0.41, P=0.045) in comparison with normal
subjects at 0.25 degrees  eccentricity.ConclusionWe found lack of an association
between MPOD and obesity in the South-Indian population. A similar finding was
also noted on age group- and gender-wise analyses.Eye advance online
publication, 6 January 2012; doi:10.1038/eye.2011.328.

PMID: 22222262  [PubMed - as supplied by publisher]

26: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Comment on 'Phakic intraocular lenses outcomes and complications: Artisan vs
Visian ICL'

Nguyen DQ, Toh TY, Ruddle JB, Crowston JG, Coote MC.

1] Royal Victorian Eye and Ear Hospital, Melbourne, Australia [2] Centre of Eye
Research Australia, Melbourne, Australia.

PMID: 22222261  [PubMed - as supplied by publisher]

27: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

A case of African crystalline maculopathy.

Dhital A, Mohamed M.

St Thomas Hospital, London, UK.

PMID: 22222260  [PubMed - as supplied by publisher]

28: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Retractable dog leashes: are they as safe as they seem?

Waqar S, Simcock P.

West of England Eye Unit, Royal Devon and Exeter Hospital, Exeter, UK.

PMID: 22222259  [PubMed - as supplied by publisher]

29: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Reply to 'a case of African crystalline maculopathy'

Hammoudi DS, Mandelcorn E, Navajas EV, Mandelcorn M.

Department of Ophthalmology and Vision Sciences, The University of Toronto,
Toronto, ON, Canada.

PMID: 22222258  [PubMed - as supplied by publisher]

30: Eye (Lond). 2012 Jan 6; [Epub ahead of print] 

Validity of EuroQOL-5D, time trade-off, and standard gamble for age-related
macular degeneration in the Singapore population.

Au Eong KG, Chan EW, Luo N, Wong SH, Tan NW, Lim TH, Wagle AM.

1] Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital,
Singapore [2] Department of Ophthalmology and Visual Sciences, Alexandra
Hospital, Singapore [3] Singapore International Eye Cataract Retina Centre,
Mount Elizabeth Medical Centre, Singapore.

Background/aimsUtility values of age-related macular degeneration (AMD) in Asian
patients are unknown. This study aims to assess utility values and construct
validity of the EuroQOL-5D (EQ-5D), time trade-off (TTO), and standard gamble
(SG) instruments in the Singapore multi-ethnic AMD
population.MethodsCross-sectional, two-centre, institution-based study. Visual
acuity (VA), clinical AMD severity, and utility scores on the EQ-5D, TTO, and SG
were obtained from 338 AMD patients. VA was analysed in terms of the
better-seeing eye (BEVA), worse-seeing eye (WEVA), and weighted average of both
eyes (WVA). We evaluated SG on the perfect health-death (SG(death)) and
binocular perfect vision-binocular blindness (SG(blindness)) scales. Construct
validity was determined by testing a priorihypotheses relating the EQ-5D, TTO,
and SG utility scores to VA and clinical AMD severity.ResultsThe mean utilities
on the EQ-5D, TTO, SG(death), and SG(blindness) were 0.89, 0.81, 0.86, and 0.90,
respectively. EQ-5D scores correlated weakly with BEVA, WEVA, and WVA (Pearson's
correlation coefficients -0.291, -0.247, and -0.305 respectively, P<0.001 for
all). SG(death) and SG(blindness) demonstrated no correlation with BEVA, WEVA,
or WVA (Pearson's correlation coefficients, range -0.06 to -0.125). TTO showed
weak association only with WEVA and WVA (correlation coefficients -0.237,
-0.228, P<0.0001), but not with BEVA (correlation coefficient -0.161). Clinical
AMD severity correlated with EQ-5D and SG(death), but not with TTO and
SG(blindness) (P=0.004, 0.002, 0.235, and 0.069, respectively).ConclusionsAMD
has a negative impact on utilities, although utility scores were high compared
with Western cohorts. EQ-5D, TTO, and SG showed suboptimal construct validity,
suggesting that health status utilities may not be sufficiently robust for
cost-utility analyses in this population.Eye advance online publication, 6
January 2012; doi:10.1038/eye.2011.218.

PMID: 22222257  [PubMed - as supplied by publisher]