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). 2014 Nov 21. doi: 10.1038/eye.2014.262. [Epub ahead of print]

A brief review of the clinical anatomy of the vestibular-ocular connections-how
much do we know?

Bronstein AM, Patel M, Arshad Q.

Author information: 
Academic Department of Neuro-otology, Charing Cross Hospital Campus, Imperial
College London, London, UK.

The basic connectivity from the vestibular labyrinth to the eye muscles
(vestibular ocular reflex, VOR) has been elucidated in the past decade, and we
summarise this in graphic format. We also review the concept of 'velocity
storage', a brainstem integrator that prolongs vestibular responses. Finally, we 
present new discoveries of how complex visual stimuli, such as binocular rivalry,
influence VOR processing. In contrast to the basic brainstem circuits, cortical
vestibular circuits are far from being understood, but parietal-vestibular nuclei
projections are likely to be involved.Eye advance online publication, 21 November
2014; doi:10.1038/eye.2014.262.

PMID: 25412719   [PubMed - as supplied by publisher]

2. Eye (Lond). 2014 Nov 21. doi: 10.1038/eye.2014.270. [Epub ahead of print]

Pattern strabismus and torsion needs special surgical attention.

Kekunnaya R(1), Mendonca T(1), Sachdeva V(2).

Author information: 
(1)Jasti V Ramanamma Children's Eye Care Center, L V Prasad Eye Institute, KAR
campus, Hyderabad, India.
(2)Nimmagadda Prasad Children's Eye Care Center, L V Prasad Eye Institute, GMRV
Campus, Visakhapatnam, India.

Pattern strabismus is relatively common in strabismus practice. Although it is
classically used to include A and V patterns, the term has been expanded to
include additional vertically incomitant horizontal strabismus. This article
reviews the clinical features, etiopathogenesis, and surgical options for the
patients with pattern strabismus.Eye advance online publication, 21 November
2014; doi:10.1038/eye.2014.270.

PMID: 25412718   [PubMed - as supplied by publisher]

3. Eye (Lond). 2014 Nov 21. doi: 10.1038/eye.2014.249. [Epub ahead of print]

Indemnity for orthoptist-delivered intravitreal injections.

DaCosta J, Hamilton R, Nago J, Mapani A, Kennedy E, Luckett T, Pavesio C,
Flanagan D.

Author information: 
Moorfields Eye Hospital, London, UK.

PMID: 25412717   [PubMed - as supplied by publisher]

4. Eye (Lond). 2014 Nov 21. doi: 10.1038/eye.2014.276. [Epub ahead of print]

Ocular motor abnormalities in neurodegenerative disorders.

Antoniades CA, Kennard C.

Author information: 
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford UK.

Eye movements are a source of valuable information to both clinicians and
scientists as abnormalities of them frequently act as clues to the localization
of a disease process. Classically, they are divided into two main types: those
that hold the gaze, keeping images steady on the retina (vestibulo-ocular and
optokinetic reflexes) and those that shift gaze and redirect the line of sight to
a new object of interest (saccades, vergence, and smooth pursuit). Here we will
review some of the major ocular motor abnormalities present in neurodegenerative 
disorders.Eye advance online publication, 21 November 2014;

PMID: 25412716   [PubMed - as supplied by publisher]

5. Eye (Lond). 2014 Nov 21. doi: 10.1038/eye.2014.280. [Epub ahead of print]

Retrospective contralateral study comparing Descemet membrane endothelial
keratoplasty with Descemet stripping automated endothelial keratoplasty.

Maier AK(1), Gundlach E(1), Gonnermann J(1), Klamann MK(1), Bertelmann E(1),
Rieck PW(2), Joussen AM(1), Torun N(1).

Author information: 
(1)Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow
Klinikum, Charité, Germany.
(2)Eye Clinic am Kapellenberg, Potsdam, Germany.

PurposeIn this retrospective study, the visual outcomes and postoperative
complications after Descemet stripping automated endothelial keratoplasty (DSAEK)
and Descemet membrane endothelial keratoplasty (DMEK) in the fellow eye were
compared. The patient's satisfaction was evaluated.MethodsA retrospective
analysis of 10 patients, who underwent DSAEK in one eye and DMEK surgery in their
fellow eye, was performed. Intraoperative and postoperative complications were
recorded. Visual and refractive outcomes were evaluated, including higher-order
aberrations (HOA) and contrast thresholds. A subjective questionnaire was used to
evaluate patient satisfaction.ResultsBest-corrected visual acuity (BCVA) was
significantly better in DMEK when compared with DSAEK (0.16±0.10 vs 0.45±0.58
logMAR, P=0.043). Contrast threshold was significantly higher after DMEK than
after DSAEK (0.49±0.23 vs 0.25±0.18, P=0.043). Post-keratoplasty astigmatism,
mean spherical equivalent, and HOA did not differ. Nine out of ten patients
preferred the DMEK procedure. Visual outcome (4.80±1.14 vs 4.50±1.58, P=0.257),
surgery associated pain and burden (DMEK: 1.30±0.48 vs DSAEK: 1.30±0.48, P=1.0), 
estimated time for recovery and rehabilitation (27.6±54.0 vs 24.9±54.8 days,
P=0.173), and mean patient satisfaction (5.40±0.84 vs 5.00±1.05, P=0.257) were
evaluated equally.ConclusionPatient satisfaction reached high, equal values after
DMEK and after DSAEK. Nevertheless, patients preferred DMEK, if given a choice.
Reasons for the preference may include better uncorrected and BCVA, and
especially a better contrast sensitivity.Eye advance online publication, 21
November 2014; doi:10.1038/eye.2014.280.

PMID: 25412715   [PubMed - as supplied by publisher]

6. Eye (Lond). 2014 Nov 21. doi: 10.1038/eye.2014.234. [Epub ahead of print]

Utilisation of orthoptists to give intravitreal injections-a multidisciplinary

Mall SP(1), North L(2), Menon G(2), Moorman CM(1), Downes SM(1).

Author information: 
(1)Oxford Eye Hospital, Oxford Universities NHS Trust, Oxford, UK.
(2)Frimley Park Hospital NHS Foundation Trust, Surrey, UK.

PMID: 25412714   [PubMed - as supplied by publisher]

7. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.277. [Epub ahead of print]

Distance-near disparity esotropia: can we shrink the gap?

Burke JP.

Author information: 
Department of Ophthalmology, Royal Hallamshire Hospital Sheffield and the
Children's Hospital Sheffield, Sheffield, South Yorkshire, UK.

Distance-near disparity esotropias are a group of heterogenous usually acquired
strabismus disorders, where the angle of misalignment at near exceeds that at
distance by 10 prism diopters or more, where the accurate correction of
refractive errors and ambylopia are important early objectives. These
aetiologically diverse entities respond non-uniformally to strabismus surgery and
bifocals. The management challenge is one of 'shrinking' the disparity so that
the affected individuals can develop and comfortably maintain binocular single
vision and/or optimal alignment. Surgical procedures have continued to evolve but
none of the current operative procedures are superior for all patients.
Subclassifying this strabismus and highlighting publication data from more
homogenous clinical series may assist with the optimisation of future management 
and treatment outcomes.Eye advance online publication, 14 November 2014;

PMID: 25397789   [PubMed - as supplied by publisher]

8. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.272. [Epub ahead of print]

Clinical outcomes between optical path difference custom aspheric treatment and
optimized prolate ablation photorefractive keratectomy in myopia exceeding 8

Choi BJ(1), Park YM(2), Lee JS(2).

Author information: 
(1)Lee Eye Clinic, Pusan, Republic of Korea.
(2)Department of Ophthalmology, School of Medicine, Pusan National University and
Medical Research Institute, Pusan National University Hospital, Pusan, Republic
of Korea.

PurposeComparison of visual acuity, refractive, and wavefront outcomes associated
with optimized prolate ablation (OPA) and optical path difference custom aspheric
treatment (OPDCAT) algorithms for correction of myopia exceeding 8 diopters
(D).Patients and MethodsPatients were randomly assigned to have photorefractive
keratectomy (PRK) with OPA (n=32) or OPDCAT (n=21) algorithms. Visual acuity,
manifest refraction, ocular and corneal higher-order aberrations, corneal
asphericity, modulated-transfer function, and point-spread function were compared
1, 3, and 6 months postoperatively.ResultsMean manifest-refraction spherical
equivalents at 6 months were -0.24 D in both groups. All patients in both groups 
had an uncorrected-distance visual acuity of 20/20 or better. Predictability
(±1 D from intended refraction) at 6 months was 94% in the OPA group, and in the 
OPDCAT group it was 86%. The OPA group had less induced corneal and ocular
spherical aberrations (SAs) than the OPDCAT group. Postoperative corneal
asphericity change was lowest in the OPA group. Both the groups exhibited
significantly-improved AreaRatio-Total value and insignificantly deteriorated
AreaRatio-HO value throughout the postoperative period. The OPA group had
significantly-higher AreaRatio-Total compared with OPDCAT group at both 1 and 6
months after the operation. Six months after surgery, the Strehl ratio had
decreased in both groups, and there was no significant difference between the
groups.ConclusionThe OPA algorithms yielded higher-objective visual quality and
predictability, induced less corneal and ocular SAs, and preserved more
preoperative-corneal asphericity than the OPDCAT algorithms.Eye advance online
publication, 14 November 2014; doi:10.1038/eye.2014.272.

PMID: 25397788   [PubMed - as supplied by publisher]

9. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.278. [Epub ahead of print]

Reliability of vitreous histological detection of pathogenic fungi in the
diagnosis of fungal endophthalmitis.

Liu K, Fang F, Li H.

Author information: 
Department of Ophthalmology, The Second Xiangya Hospital, Central South
University, Changsha, Hunan, China.

PurposeTo assess the value of histopathologic investigations of vitreous biopsy
specimens in the diagnosis of fungal endophthalmitis compared with that of
conventional smear and fungal culture.MethodsIn this prospective study, 10
patients with clinically suspected fungal endophthalmitis of any etiology
underwent intravitreal sampling and vitrectomy for diagnostic and therapeutic
purposes. Infused vitreous biopsy samples were centrifuged and mixed with blood
serum for hematoxylin and eosin and periodic-acid Schiff staining, whereas the
remaining samples were submitted for smear and fungal culture. All slides were
reviewed by an attending pathologist.ResultsVitreous specimens were obtained from
10 eyes of 10 patients. Positive histological diagnoses of fungal endophthalmitis
from vitreous biopsies were made in seven cases (70%). The sensitivity of
histological detection of fungi was higher than conventional smear (50%) or
culture (40%); all these techniques are complementary.ConclusionsSpecific
histopathological detection of pathogenic fungi in clinical vitreous specimens
could be helpful for the diagnosis of suspected fungal endophthalmitis. Positive 
histopathology results were seen in the majority of samples; however,
difficulties in determining related fungal etiology limit its application.Eye
advance online publication, 14 November 2014; doi:10.1038/eye.2014.278.

PMID: 25397787   [PubMed - as supplied by publisher]

10. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.267. [Epub ahead of print]

Response to O'Brart: 'Is accelerated cross-linking the way forward? Yes or No'

Tsatsos M(1), MacGregor C(1), Kopsachilis N(2), Hossain P(1), Anderson D(1).

Author information: 
(1)Southampton Eye Unit, Southampton University Hospitals NHS Trust, Southampton,
(2)Whipps Cross University Hospital Eye Unit, London, UK.

Eye advance online publication, 14 November 2014; doi:10.1038/eye.2014.267.

PMID: 25397786   [PubMed - as supplied by publisher]

11. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.269. [Epub ahead of print]

How does the structure of extraocular muscles and their nerves affect their

Bruenech JR(1), Kjellevold Haugen IB(2).

Author information: 
(1)Biomedical Research Unit, Faculty of Health Sciences, Buskerud and Vestfold
University College, Campus Kongsberg, Kongsberg, Norway.
(2)Institute for Biomedical Sciences, Oslo, Norway.

The sensory and motor control of human extraocular muscles (EOMs) have been
subjected to considerable speculation in ophthalmic literature, often related to 
infranuclear structures such as the unique complement of muscle fibres and their 
associated sensory organs. The intrafusal fibres do not resemble their somatic
counterparts and their peculiar morphology has raised questions about their
proprioceptive capacity. No Golgi tendon organs have so far been observed and the
myotendinous nerve endings, previously assumed to convey sensory information,
have recently been argued to merely represent constituents of the efferent
innervation serving the multiply innervated muscles fibres. These observations
raise questions about the overall capacity to monitor the activity created by the
generous efferent nerve supply observed in these muscles. Furthermore, the argued
independent activity of muscular layers and compartments suggest that the
required feedback must be highly structured and more specific than previously
assumed. Yet, uncertainty about the source of such information remains. The
purpose of this paper is to provide a short review of neuromuscular properties of
human extraocular muscles. Their functional implications and the most reputable
sources of proprioception will also be discussed. The promoted views are based on
pertinent literature and previous research undertaken by the authors.Eye advance 
online publication, 14 November 2014; doi:10.1038/eye.2014.269.

PMID: 25397785   [PubMed - as supplied by publisher]

12. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.250. [Epub ahead of print]

Visual outcome and incidence of glaucoma in patients with microspherophakia.

Muralidhar R, Ankush K, Vijayalakshmi P, George VP.

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

IntroductionA number of ocular complications have been reported in
microspherophakia. The literature however is limited to small case reports and
the incidence of these complications is largely unknown. Our study describes a
series of patients who presented to our hospital from 1998 to 2008.Material and
methodsData on the clinical and surgical findings of patients presented to us
from 1998 to 2008 with microspherophakia were retrieved from the medical records 
and the results analyzed.ResultsThirty-six eyes of 18 patients were reviewed. The
mean age at presentation was 16±10 years. All patients had varying degrees of
lenticular myopia with a mean of -11.07±5.03 D. Glaucoma developed in 16 eyes
(44.4%). Half of them had high IOP at presentation. Despite medical and surgical 
management IOP remained high in five eyes at the last follow-up. Sixteen eyes
(44.4%) required lensectomy for dislocated crystalline lens. Lensectomy did not
have any impact on the intraocular pressures. Homocysteinuria was the most common
systemic association noted.ConclusionMicrospherophakia is associated with a high 
incidence of lenticular myopia, subluxation of the crystalline lens and glaucoma.
Management of glaucoma is difficult with the IOP remaining high in spite of
combined medical and surgical management.Eye advance online publication, 14
November 2014; doi:10.1038/eye.2014.250.

PMID: 25397784   [PubMed - as supplied by publisher]

13. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.275. [Epub ahead of print]

Eye movements and their functions in everyday tasks.

Foulsham T.

Author information: 
Department of Psychology, University of Essex, Colchester, UK.

Human saccades and fixations have numerous functions in complex everyday tasks,
which have sometimes been neglected in simple experimental situations. In this
review I describe some of the characteristics of eye movement behaviour during
real-world interactions with objects, while walking in natural environments and
while holding a conversation. When performing real-world actions and walking
around the world, we fixate relevant features at critical time points during the 
task. The eye movements between these fixations are planned and coordinated
alongside head and body movements, often occurring a short time before the
corresponding action. In social interactions, eye movements are both a mechanism 
for taking in information (for example, when looking at someone's face or
following their gaze) and for signalling one's attention to another person. Thus 
eye movements are specific to a particular task context and subject to high-level
planning and control during everyday actions.Eye advance online publication, 14
November 2014; doi:10.1038/eye.2014.275.

PMID: 25397783   [PubMed - as supplied by publisher]

14. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.268. [Epub ahead of print]

Is intermittent exotropia a curable condition?

Holmes JM, Hatt SR, Leske DA.

Author information: 
Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA.

Surgical treatment of childhood intermittent exotropia (XT) is associated with
high recurrence rates. In addition, the natural history of intermittent XT has
not been rigorously studied and, anecdotally, some cases resolve without surgery.
We compared long-term cure rates in children with surgically and non-surgically
managed intermittent XT. Children undergoing surgery for intermittent XT who had 
5 years follow-up were retrospectively identified. A non-surgical cohort of
comparable children was selected by matching each surgical patient for age at
onset and age at the 5-year examination. Cure was defined as no manifest tropia
on examination or by history, no new monofixation (stereoacuity subnormal for
age), and no additional surgery. Each group had 33 children (total follow-up from
presentation 7.2±2.6 years in the surgical group vs 6.8±2.3 years). There were no
significant differences between groups for age at onset, age at presentation, or 
distance or near angle of deviation at presentation (all P≥0.4). The cure rate at
5 years was 30% in the surgical group and 12% in the non-surgical group (P=0.1;
difference 18%, 95% CI -1 to 37%). Only a small proportion of surgical and
non-surgical patients met our definition of cure, with the vast majority
demonstrating a constant or intermittent manifest deviation after an average of 7
years follow-up. In childhood intermittent XT, long-term cure is difficult to
achieve with surgical intervention, and in some patients managed non-surgically
the intermittent XT will spontaneously resolve.Eye advance online publication, 14
November 2014; doi:10.1038/eye.2014.268.

PMID: 25397782   [PubMed - as supplied by publisher]

15. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.274. [Epub ahead of print]

Is accelerated corneal cross-linking for keratoconus the way forward? Yes or No.

O'Brart DS.

Author information: 
Department of Ophthalmology, Guy's and St Thomas NHS Foundation Trust, London,

Eye advance online publication, 14 November 2014; doi:10.1038/eye.2014.274.

PMID: 25397781   [PubMed - as supplied by publisher]

16. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.265. [Epub ahead of print]

Re: 'Fellow eye effect of unilateral intravitreal bevacizumab injection in eyes
with diabetic macular edema'

Sharma NS, Ong JM, Ooi JL.

Author information: 
Medical Retina, Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital,
Cambridge, UK.

PMID: 25397780   [PubMed - as supplied by publisher]

17. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.261. [Epub ahead of print]

Fellow eye effect of unilateral intravitreal anti-VEGF injections in eyes with
diabetic macular edema.

Hanhart J(1), Chowers I(2).

Author information: 
(1)1] Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel
[2] Department of Ophthalmology, Hadassah-Hebrew University Medical Center,
Jerusalem, Israel.
(2)Department of Ophthalmology, Hadassah-Hebrew University Medical Center,
Jerusalem, Israel.

PMID: 25397779   [PubMed - as supplied by publisher]

18. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.271. [Epub ahead of print]

The cerebellum in eye movement control: nystagmus, coordinate frames and

Patel VR(1), Zee DS(2).

Author information: 
(1)Associate Professor of Ophthalmology, USC Eye Institute, Keck School of Medicine,
University of Southern California, Los Angeles, CA, USA.
(2)Professor of Neurology, Otolaryngology, Head and Neck Surgery, Path 2-200 Johns
Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD,

In this review we discuss several aspects of eye movement control in which the
cerebellum is thought to have a key role, but have been relatively ignored. We
will focus on the mechanisms underlying certain forms of cerebellar nystagmus, as
well as the contributions of the cerebellum to binocular alignment in healthy and
diseased states. A contemporary review of our understanding provides a basis for 
directions of further inquiry to address some of the uncertainties regarding the 
contributions of the cerebellum to ocular motor control.Eye advance online
publication, 14 November 2014; doi:10.1038/eye.2014.271.

PMID: 25397778   [PubMed - as supplied by publisher]

19. Eye (Lond). 2014 Nov;28(11):1394. doi: 10.1038/eye.2014.238.

A novel deletion mutation in RS1 gene caused X-linked juvenile retinoschisis in a
Chinese family.

Huang Y, Mei L, Gui B, Su W, Liang D, Wu L, Pan Q.

PMID: 25393829   [PubMed - in process]

20. Eye (Lond). 2014 Nov;28(11):1393. doi: 10.1038/eye.2014.228.

Prevalence of glaucoma in patients with moderate to severe obstructive sleep
apnea: ocular morbidity and outcomes in a 3 year follow-up study.

Hashim SP, Al Mansouri FA, Farouk M, Al Hashemi AA, Singh R.

PMID: 25393828   [PubMed - in process]

21. Eye (Lond). 2014 Nov 7. doi: 10.1038/eye.2014.260. [Epub ahead of print]

Drusen and RPE atrophy automated quantification by optical coherence tomography
in an elderly population.

Diniz B(1), Rodger DC(2), Chavali V(3), MacKay T(3), Lee SY(2), Stambolian D(3), 
Sadda SV(2).

Author information: 
(1)1] Doheny Eye Institute, Los Angeles, CA, USA [2] Department of Ophthalmology,
Universidade Federal de São Paulo, São Paulo, Brazil.
(2)1] Doheny Eye Institute, Los Angeles, CA, USA [2] Department of Ophthalmology,
Keck School of Medicine of the University of Southern California, Los Angeles,
(3)Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA.

PurposeCorrelate OCT-derived measures of drusen and retinal pigment epithelium
(RPE) atrophy areas (RAs) with demographic features in an elderly
population.Patients and methodsSubjects aged 50 years and older underwent Cirrus 
OCT scanning. Drusen area and volume were obtained from the macula within a
central circle (CC) of 3 mm and a surrounding perifoveal ring (PR) of 3-5 mm,
using the RPE analysis software (6.0). RA measurements were generated for the 6 ×
6 mm(2) retinal area. Gender, age, smoking status, and systolic blood pressure
(SBP) were considered.ResultsA total of 434 eyes were included. RA was larger in 
women (0.63±0.16 vs 0.26±0.08 mm(2), P=0.05) and with increasing age. The PR
drusen area increased with increasing age (P<0.001), whereas the CC drusen area
remained stable after the age of 70 years (0.25±0.06 mm(2) for ages 70-79 years
and 0.25±0.07 mm(2) for ages >80 years). Drusen volume in the CC was smaller
after the age of 80 years (0.009±0.003 mm(3)) compared with the 70- to
79-year-old group (0.02±0.008 mm(3)). Drusen measurements were similar between
smokers and nonsmokers, but the PR drusen area (0.29 mm(2), P=0.05) and volume
(0.40 mm(3), P=0.005) were correlated with years smoked. RA (0.24 mm(2), P=0.10),
PR drusen area (0.29 mm(2), P=0.05), and volume (0.40 mm(3), P=0.005) were found 
to be directly associated with SBP. There was a high correlation between the eyes
of the same subject.ConclusionOCT-based automated algorithms can be used to
analyze and describe drusen and geographic atrophy burden in such
population-based studies of elderly patients.Eye advance online publication, 7
November 2014; doi:10.1038/eye.2014.260.

PMID: 25376121   [PubMed - as supplied by publisher]

22. Eye (Lond). 2014 Nov 7. doi: 10.1038/eye.2014.256. [Epub ahead of print]

Posterior staphyloma is related to optic disc morphology and the location of
visual field defect in normal tension glaucoma patients with myopia.

Park HY, Jung Y, Park CK.

Author information: 
Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital,
College of Medicine, The Catholic University of Korea, Seoul, Korea.

PurposeTo determine the morphologic features of the optic disc and the location
of visual field (VF) defect in relation to posterior staphyloma in normal tension
glaucoma (NTG) eyes with myopia.MethodsOne hundred and thirty-four NTG patients
with myopia were enrolled. B-scan ultrasonography was performed in enrolled
patients. Disc tilt ratio, disc torsion, and area of peripapillary atrophy were
measured from disc photographs. Patients were classified according to the
presence of posterior staphyloma and its location: staphyloma involving the optic
disc, staphyloma involving either the supero-temporal side of the optic disc or
the infero-temporal side of the optic disc. The relationship between the location
of the posterior staphyloma and that of the VF defect was analyzed.ResultsAmong
134 eyes, 74 eyes (55.2%) had posterior staphyloma on B-scan ultrasonography.
Mean torsion degree was significantly greater in eyes with staphyloma involving
the temporal side of the optic disc (19.78±18.00°) compared with eyes with
staphyloma involving the optic disc (4.65±4.92°, P=0.001). The frequency of the
location of VF damage differed significantly between eyes with staphyloma
involving the supero-temporal side and those involving the infero-temporal side
of the optic disc (P=0.008), which was not significant in eyes with staphyloma
involving the optic disc (P=0.813).ConclusionsOptic disc torsion was a prominent 
finding in myopic NTG eyes when posterior staphyloma was located temporal to the 
optic disc. The location of posterior staphyloma was related to the direction of 
disc torsion and the location of VF defect.Eye advance online publication, 7
November 2014; doi:10.1038/eye.2014.256.

PMID: 25376120   [PubMed - as supplied by publisher]

23. Eye (Lond). 2014 Nov 7. doi: 10.1038/eye.2014.263. [Epub ahead of print]

Neuropathic ocular pain: an important yet underevaluated feature of dry eye.

Galor A(1), Levitt RC(2), Felix ER(3), Martin ER(4), Sarantopoulos CD(5).

Author information: 
(1)1] Miami Veterans Administration Medical Center, Miami, FL, USA [2] Bascom Palmer
Eye Institute, University of Miami, Miami, FL, USA.
(2)1] Miami Veterans Administration Medical Center, Miami, FL, USA [2] Department of
Anesthesiology, Perioperative Medicine and Pain Management, University of Miami
Miller School of Medicine, Miami, FL, USA [3] John P Hussman Institute for Human 
Genomics, University of Miami Miller School of Medicine, Miami, FL, USA [4] John 
T Macdonald Foundation Department of Human Genetics, University of Miami Miller
School of Medicine, Miami, FL, USA.
(3)1] Miami Veterans Administration Medical Center, Miami, FL, USA [2] Department of
Physical Medicine and Rehabilitation, University of Miami Miller School of
Medicine, Miami, FL, USA.
(4)1] John P Hussman Institute for Human Genomics, University of Miami Miller School
of Medicine, Miami, FL, USA [2] John T Macdonald Foundation Department of Human
Genetics, University of Miami Miller School of Medicine, Miami, FL, USA.
(5)1] Miami Veterans Administration Medical Center, Miami, FL, USA [2] Department of
Anesthesiology, Perioperative Medicine and Pain Management, University of Miami
Miller School of Medicine, Miami, FL, USA.

Dry eye has gained recognition as a public health problem given its prevalence,
morbidity, and cost implications. Dry eye can have a variety of symptoms
including blurred vision, irritation, and ocular pain. Within dry eye-associated 
ocular pain, some patients report transient pain whereas others complain of
chronic pain. In this review, we will summarize the evidence that chronicity is
more likely to occur in patients with dysfunction in their ocular sensory
apparatus (ie, neuropathic ocular pain). Clinical evidence of dysfunction
includes the presence of spontaneous dysesthesias, allodynia, hyperalgesia, and
corneal nerve morphologic and functional abnormalities. Both peripheral and
central sensitizations likely play a role in generating the noted clinical
characteristics. We will further discuss how evaluating for neuropathic ocular
pain may affect the treatment of dry eye-associated chronic pain.Eye advance
online publication, 7 November 2014; doi:10.1038/eye.2014.263.

PMID: 25376119   [PubMed - as supplied by publisher]

24. Eye (Lond). 2014 Nov 14. doi: 10.1038/eye.2014.264. [Epub ahead of print]

Efficacy of subthreshold micropulse laser in the treatment of diabetic macular
edema is influenced by pre-treatment central foveal thickness.

Mansouri A, Sampat KM, Malik KJ, Steiner JN, Glaser BM.

Author information: 
The National Retina Institute, Towson, MD, USA.

PurposeTo determine if the severity of diabetic macular edema influences the
effectiveness of subthreshold micropulse (STMP) laser treatment.MethodsA total of
63 eyes of 58 patients with diabetic macular edema were divided into two groups
based on their initial central foveal thickness (CFT). Group 1 had CFT ≤400 μm,
group 2 had CFT >400 μm. The change from baseline in CFT and visual acuity were
compared at 3, 6 and 12 months follow-up. Patients were considered for
retreatment with micropulse laser at 3 months if macular edema had not improved. 
Patients were considered for rescue anti-VEGF injections if there was clinically 
significant macular edema at 6 months follow-up. Number of laser retreatments,
injections, and any adverse effects from STMP laser were recorded.ResultsGroup 1 
(n=33) experienced an average of 55 μm reduction in CFT and 0.2log MAR gain in
visual acuity at 12 months (P<0.001). No patient required rescue anti-VEGF
injections. Group 2 (n=30) experienced no significant change in CFT or visual
acuity by 6 months despite retreatment with STMP in 19 eyes. From 6 to 12 months 
follow-up, all the patients in group 2 received rescue Bevacizumab injections
that resulted in 307 μm reduction in CFT and 0.3log MAR improvement in visual
acuity (P<0.001). No adverse effects from STMP laser were
recorded.ConclusionSeverity of edema can influence the effects of STMP laser.
STMP monotherapy is safe and effective in treating edema of mild to moderate
severity.Eye advance online publication, 14 November 2014;

PMID: 25359290   [PubMed - as supplied by publisher]

25. Eye (Lond). 2014 Nov 7. doi: 10.1038/eye.2014.258. [Epub ahead of print]

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

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

Author information: 
Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital,
Fondation Asile des aveugles, Lausanne, Switzerland.

PurposeThe purpose of this study was to report the 2-year outcome of an
individually tailored 'observe-and-plan' treatment regimen for neovascular
age-related macular degeneration (nAMD), and to investigate its clinical value in
terms of functional outcome. This regimen aimed to reduce the clinical burden
(visits) by employing individually fixed injection intervals, based on the
predictability of an individual's need for retreatment.MethodsThis prospective
case series included 104 patients (115 eyes) with nAMD. Following three loading
doses of ranibizumab, the disease recurrence interval was determined in monthly
observation visits. Retreatment was applied in a series of three injections with 
individually fixed intervals (2 weeks shorter than the recurrence interval),
combined with periodic adjustment of the intervals. The allowed injection
intervals in treatment plans ranged from 1 to 3 months. If there was no
recurrence at 3 months, the patient could change to monitoring alone.ResultsMean 
visual acuity (VA) improved by 8.7, 9.7, and 9.2 letters at months 3, 12, and 24,
respectively. The mean number of injections was 7.8 and 5.8 during years 1 and 2,
respectively, whereas the mean number of ophthalmic examinations was 4.0 and 2.9,
respectively. The mean treatment interval (after the loading doses) was 2.0
months during year 1, and 2.2 months during year 2.ConclusionThe observe-and-plan
regimen significantly improved and maintained VA over the course of 2 years. This
favourable functional outcome was achieved with fewer clinic visits compared with
other regimens. Therefore, this observe-and-plan regimen has the potential to
alleviate the clinical burden of nAMD treatment.Eye advance online publication, 7
November 2014; doi:10.1038/eye.2014.258.

PMID: 25359289   [PubMed - as supplied by publisher]

26. Eye (Lond). 2014 Oct 31. doi: 10.1038/eye.2014.253. [Epub ahead of print]

Larger and near-term baby retinopathy: a rare case series.

Padhi TR(1), Rath S(1), Jalali S(2), Pradhan L(3), Kesarwani S(1), Nayak M(4),
Mishra B(5), Panda KG(1), Suttar S(1).

Author information: 
(1)Retina-Vitreous Services, L V Prasad Eye Institute, Bhubaneswar, India.
(2)Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye
Institute, Hyderabad, India.
(3)Infosys Pediatric Center, Capital Hospital, Bhubaneswar, India.
(4)Department of Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneswar,
(5)Pediatric Unit, Jagannath Hospital, Bhubaneswar, India.

PurposeTo report retinopathy in a series of four babies unusually beyond the
screening standards reported so far in the literature.MethodsDuring routine
screening for retinopathy of prematurity, we detected retinopathy in four babies 
who were surprisingly bigger and older than the screening standards. The
gestational age (GA), birth weight (BW), post menstrual age at first examination 
and significant perinatal events were noted. The retinopathy details imaged by
the RetCam were classified as per ICROP revisited standards.ResultThe GA ranged
from 36 to 39 weeks and BW from 2.4 to 3.0 kg. Three of them had retinopathy in
zone III that regressed spontaneously and one had marked plus with vascular
arcades and shunts in zone II that regressed after laser photocoagulation. All of
them had fetal distress and multiple systemic comorbidities in the neonatal
period.ConclusionThis report makes one aware of the possibility of retinopathy in
newborn of older GA and larger BW especially with fetal distress and stormy
neonatal course.Eye advance online publication, 31 October 2014;

PMID: 25359288   [PubMed - as supplied by publisher]

27. Eye (Lond). 2014 Nov 7. doi: 10.1038/eye.2014.255. [Epub ahead of print]

Relationship between paravascular abnormalities and foveoschisis in highly myopic

Kamal-Salah R(1), Morillo-Sanchez MJ(2), Rius-Diaz F(3), Garcia-Campos JM(4).

Author information: 
(1)Department of ophthalmology, Centro de Investigaciones Médico-Sanitarias, Málaga,
(2)Department of ophthalmology, Hospital Virgen de la Victoria de Málaga, Málaga,
(3)Department of Biostatistics, University of Malaga, Málaga, Spain.
(4)1] Department of ophthalmology, Centro de Investigaciones Médico-Sanitarias,
Málaga, Spain [2] Department of ophthalmology, Hospital Virgen de la Victoria de 
Málaga, Málaga, Spain.

PurposeTo describe the prevalence of paravascular abnormalities in highly myopic 
patients and its relationship with myopic foveoschisis
(MF).MethodsCross-sectional study of 250 highly myopic eyes. All of the patients 
underwent a complete ophthalmologic examination that included optical coherence
tomography .ResultsOptical coherence tomography images showed 170 eyes (68%) with
paravascular microfolds (PM), 121 eyes (48.4%) presented paravascular retinal
cysts (PC), and 35 eyes (14%) with paravascular lamellar holes . All the eyes
with PCs had PMs. Out of the 250 eyes, 48 (19.2%) had paravascular retinoschisis 
(PR). All the eyes (100%) with PR had paravascular cysts and PMs. Sixteen eyes
(6.4%) had foveoschis. The spherical equivalent (P<0.00), PR (P=0.01), and the
presence of tractional structures (P<0.00) were associated with increased risk
for foveoschsis in the multivariate study.ConclusionsPMs were the lesions most
often observed in the paravascular area in highly myopic eyes. MF would be a
result of the action of different forces (intra- and extra-ocular forces),
specially tractional structures, on precursor lesions (paravascular cyst and
paravascular restinoschisis). Further studies are needed to confirm these
results.Eye advance online publication, 7 November 2014;

PMID: 25359287   [PubMed - as supplied by publisher]

28. Eye (Lond). 2014 Oct 31. doi: 10.1038/eye.2014.254. [Epub ahead of print]

Association of polymorphisms of angiotensin I converting enzyme 2 with
retinopathy in type 2 diabetes mellitus among Chinese individuals.

Meng N, Zhang Y, Ma J, Li H, Zhou F, Qu Y.

Author information: 
Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China.

AimsTo examine the association of Angiotensin I converting enzyme 2 (ACE2) gene
polymorphisms and retinopathy in a Chinese type 2 diabetes mellitus (T2DM)
cohort.MethodsA total of 743 T2DM participants were involved in this study
including 408 female and 335 male cases. Female cases were divided into two
groups: diabetes without retinopathy (DNR group, n=171) and with retinopathy (DR 
group, n=237), the latter was further subclassified into nonproliferative DR
(NPDR group, n=121) and proliferative DR (PDR group, n=116). Male cases were
assigned to DNR group (n=153) and DR group (n=182) which was further grouped into
NPDR group (n=86) and PDR group (n=96). Two single nucleotide polymorphisms
(SNPs; rs2074192 and rs714205) in ACE2 gene were genotyped.ResultsIn female
cases, the frequency of genotypes TT in rs2074192 and CC in rs714205 were higher 
in DR and PDR group than in DNR group (P<0.05). The frequency of alleles T in SNP
rs2074192 and C in SNP rs714205 was higher in DR group (P<0.05) and PDR group
(P<0.05) than in DNR group. The frequency of allele T in SNP rs2074192 was higher
in PDR group (P=0.04) than in NPDR group. The frequency of haplotype TC and CG
was higher in DR and PDR groups, respectively (P<0.05). No positive results were 
found in male cases.ConclusionsOur results revealed that SNPs rs2074192 and
rs714205 in ACE2 gene were associated with the susceptibility of DR and PDR.Eye
advance online publication, 31 October 2014; doi:10.1038/eye.2014.254.

PMID: 25359286   [PubMed - as supplied by publisher]

29. Eye (Lond). 2014 Oct 31. doi: 10.1038/eye.2014.273. [Epub ahead of print]

Deep anterior lamellar keratoplasty-triple procedure: a useful clinical
application of the pre-Descemet's layer (Dua's layer).

Zaki AA(1), Elalfy MS(2), Said DG(2), Dua HS(3).

Author information: 
(1)Research Institute of Ophthalmology, Cairo, Egypt.
(2)1] Research Institute of Ophthalmology, Cairo, Egypt [2] Academic Ophthalmology, 
Division of Clinical Neuroscience, B Floor, Eye ENT Centre, Queens Medical
Centre, University of Nottingham, Nottingham, UK.
(3)Academic Ophthalmology, Division of Clinical Neuroscience, B Floor, Eye ENT
Centre, Queens Medical Centre, University of Nottingham, Nottingham, UK.

PurposeTo describe a technique which exploits the transparency and toughness of
the pre-Descemets layer (Dua's layer) to safely perform deep anterior lamellar
keratoplasty (DALK) and phacoemulsification at the same time.MethodsThree DALK
procedures combined with phacoemulsification were performed by the same surgeon
using the big-bubble (BB) technique at the Research Institute of Ophthalmology,
Cairo, Egypt. In two cases a type-1 BB, baring Dua's layer, was achieved and in
one case a type-2 BB, baring the Descemet's membrane (DM), was achieved. The
surgeries were video recorded and photo slit-lamp images were taken in the
follow-up visits.ResultsDALK with phacoemulsification and lens implant was
carried out in both patients where a type-1 BB was achieved. At a follow up of 18
months (first case) and 6 months (second case), the best corrected vision was
6/12 for each. In the case where a type-2 BB was achieved, the DM ruptured during
injection of viscoelastic prior to capsulorhexis. The procedure was converted to 
a penetrating keratoplasty without phacoemulsification.ConclusionWhen a type-1 BB
is achieved simultaneous DALK and phacoemulsification can be safely accomplished.
Dua's layer allows a clear view for performing phacoemulsification with the added
benefit of its toughness, which can maintain a stable anterior chamber for
cataract surgery. This should not be attempted when a type-2 BB is achieved.Eye
advance online publication, 31 October 2014; doi:10.1038/eye.2014.273.

PMID: 25359285   [PubMed - as supplied by publisher]