Journal Contents

Am Jour Ophthalmol
Br J Ophthalmol
Can J Ophthalmol
J Cat Ref Surg
Curr Eye Res
Eur J Ophthalmol
J Glaucoma
JAMA Ophthalmol
Graefes Ophthalmol
Indian J Ophthalmol
Int Ophthalmol Clin
Invest Ophth Vis Sci
Jpn J Ophthalmol
Korean J Ophthal
J Neuroophthalmol
Ophthalmic Epidemiol
Ophthalmic Genet
Ophthal Plast Rec Surg
Ophthalmic Res
Surv Ophthalmol
Ophthalmology Review Journal
Eye[JOUR] Established 1995
1. Eye (Lond). 2015 Oct 2. doi: 10.1038/eye.2015.184. [Epub ahead of print]

Clinical features of intratarsal keratinous cysts.

Kim JA(1), Kim N(2), Choung HK(3), Lee MJ(4), Lee C(5), Khwarg SI(1).

Author information: 
(1)Department of Ophthalmology, Seoul National University College of Medicine,
Seoul, Korea. (2)Department of Ophthalmology, Seoul National University Bundang
Hospital, Seongnam, Korea. (3)Department of Ophthalmology, Seoul Metropolitan
Government-Seoul National University Boramae Medical Center, Seoul, Korea.
(4)Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, 
Korea. (5)Department of Pathology, Seoul National University College of Medicine,
Seoul, Korea.

PurposeIntratarsal keratinous cysts (IKCs) have been frequently misdiagnosed as
chalazia or epidermal cysts. We reviewed a series of cases of IKCs to identify
clinical features that distinguish IKCs from other eyelid diseases.MethodsWe
retrospectively reviewed the medical records of 17 suspected IKC patients between
January 2004 and September 2014.ResultsSeventeen patients who were clinically
suspected to have IKC were enrolled. All patients presented with non-inflamed
eyelid nodules fixed to the tarsus. Among them, 12 biopsy specimens were
available and 11 patients (91.7%) were diagnosed with IKC, with a pathological
finding of stratified squamous cell lining with keratin material. The mean
patient age was 55.1 years (31-71). Six patients had a surgical history of
incision or incomplete excision of the lesion, followed by recurrence. On eyelid 
eversion, five patients showed a white-yellow nodule, and three patients had a
bluish cystic lesion. The diameter of the nodules ranged from 4 to 10 mm. The
intracystic material was a milky white fluid. Ten patients underwent a complete
surgical excision including partial tarsectomy and there was no
recurrence.ConclusionsIKC can be distinguished from other intratarsal lesions by 
a characteristic tarsal nodule fixed to the tarsus. To prevent recurrence,
complete excision with partial tarsectomy is needed.Eye advance online
publication, 2 October 2015; doi:10.1038/eye.2015.184.

PMID: 26427989   [PubMed - as supplied by publisher]

2. Eye (Lond). 2015 Oct 2. doi: 10.1038/eye.2015.171. [Epub ahead of print]

Vision-related quality of life, metamorphopsia, and stereopsis after successful
surgery for rhegmatogenous retinal detachment.

Lina G(1), Xuemin Q(1), Qinmei W(1), Lijun S(1).

Author information: 
(1)Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

PurposeTo determine the relationship between vision-related quality of life,
metamorphopsia, and stereopsis after successful surgery to correct rhegmatogenous
retinal detachment (RRD).Patients and methodsData were obtained from 30 patients 
with RRD who had scleral buckle surgery or vitrectomy. Age, gender, duration of
blurred vision, the best-corrected visual acuity (BCVA), extent of detachment,
and the location of retinal tears were measured before surgery. Approximately 1
year after surgery, stereopsis was measured with the Randot stereo test, visual
acuity (VA) was measured using a Snell VA acuity measurement at a distance of 5 m
and was presented as a linear LogMAR value, metamorphopsia was examined using an 
M-chart, and vision-related quality of life was determined using the 25-Item
National Eye Institute Visual Function Questionnaire (VFQ-25).ResultsAll of the
patients achieved anatomical retinal reattachment. There was a significant
difference between preoperative BCVA (0.78±0.72) and BCVA 1 year postoperatively 
(0.25±0.25) (P<0.05). Twenty-three patients had visual distortion
postoperatively, including vertical metamorphopsia (0.53±0.52°), and horizontal
metamorphopsia (0.48±0.53°). Twenty patients had no stereopsis. The composite
score of VFQ-25 was 76.60 postoperatively. Significant differences in
postoperative BCVA, metamorphopsia, and VFQ-25 were found between macula-on and
macula-off groups (all P<0.05). There was a negative correlation between VFQ-25
composite score and metamorphopsia (P<0.005); there was no significant
correlation between VFQ-25 composite score and BCVA or
stereopsis.ConclusionVision-related quality of life correlated with
metamorphopsia, but did not correlate with VA or stereopsis.Eye advance online
publication, 2 October 2015; doi:10.1038/eye.2015.171.

PMID: 26427988   [PubMed - as supplied by publisher]

3. Eye (Lond). 2015 Oct 2. doi: 10.1038/eye.2015.182. [Epub ahead of print]

Evaluation the adjunctive use of combined bevacizumab and mitomycinc to
trabeculectomy in management of recurrent pediatric glaucoma.

Mahdy RA(1), Al-Mosallamy SM(1), Al-Aswad MA(1), Bor'i A(1), El-Haig WM(1).

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

PurposeTo evaluate the efficacy and safety of combined bevacizumab-mitomycin c
(MMC) in recurrent cases of pediatric glaucoma.MethodsA prospective non-masked
controlled study that included bilateral cases of 12 patients (24 eyes) with
recurrent (had previous glaucoma surgery before) pediatric glaucoma. One eye in
each patient (12 eyes) was assigned to trabeculectomy operation with combined
application of MMC (0.4 mg/ml for 3 min) under and around the scleral flap before
trabeculectomy and bevacizumab (avastin) (2.5 mg in 0.2 ml) injected
subconjunctivally around the bleb after completing the surgery (group I). The
other eye of each patient (12 eyes) was assigned to trabeculectomy operation with
application of MMC (0.4 mg/ml for 3 min) only (group II). The mean follow-up
period was 13±1 months.ResultsThe mean age was 2.16±1.5 (range 7 months to 4.1
years). No significant difference in preoperative intraoperative pressure (IOP)
was observed between the groups (P>0.05). Recurrent primary congenital glaucoma
represents 66.7% of the cases. Other cases included were recurrent aphakic and
pseudophakic glaucoma 25% and recurrent post uveitic glaucoma 8.3%. The mean IOP 
was 12.1±4.2, 12.6±5.4, and 12.8±5.2 mm Hg in group I at 3, 6, and 12 months,
respectively, and was 12.8±5.3, 13.7±6.7 and 15.6±5.9 mm Hg in group II at 3, 6, 
and 12 months, respectively. There was a statistically significant difference in 
the mean IOP between the studied groups at the 1-year follow-up visit (P<0.05).
In addition, group I showed a higher statistically significant difference in
absolute and total success (75 and 91.7%, respectively) compared with group II
(58.3 and 75%, respectively) (P<0.05). The encountered complications included
mild hyphema, which occurred in 8.33% in group 1, wound leakage, which occurred
in 8.33% in each group, and shallow anterior chamber (AC), which occurred in
16.7% in each group and was the most common encountered complication in the
study. One case of shallow AC in group I led to choroidal effusion (8.33%). One
case in group II developed late bleb-related endophthalmitis after 3 months,
which resulted in phthisis bulbi (8.33%).ConclusionThe additive effect of
subconjunctival bevacizumab to MMC-augmented trabeculectomy in the case of
recurrent pediatric glaucoma was beneficial in improving the success rate. Better
IOP control and prolonging the bleb survivalvia reducing the long-term need of
using anti-glaucoma drugs postoperatively without adding complications had also
been achieved with this technique. This offers a promising alternative for the
treatment of this type of glaucoma.Eye advance online publication, 2 October
2015; doi:10.1038/eye.2015.182.

PMID: 26427987   [PubMed - as supplied by publisher]

4. Eye (Lond). 2015 Oct 2. doi: 10.1038/eye.2015.185. [Epub ahead of print]

Chloroquine retinopathy: pattern of presentation in Ibadan, Sub-Sahara Africa.

Oluleye TS(1), Babalola Y(1), Ijaduola M(1).

Author information: 
(1)Retina and Vitreous Unit, Department of Ophthalmology, University College
Hospital, Ibadan, Nigeria.

BackgroundSelf-medication with chloroquine is common in Ibadan, Sub-Sahara
Africa. Retinopathy from chloroquine is not uncommon. The aim was to determine
the pattern of presentation.MethodologyCases of Chloroquine retinopathy seen at
the Retina and Vitreous Unit of the University College Hospital, Ibadan between
2008 and 2014 were reviewed. Information on age, sex, duration of chloroquine
use, and visual loss were retrieved. Visual acuity at presentation, anterior, and
posterior segment findings were documented. The results were analyzed using
proportions and percentages.ResultsFourteen cases were seen during the study
period. Mean age was 50.7 years. Male to female ratio was 3.5 : 1. Average
duration of visual loss before presentation was 2.7 years. Average duration of
self-medication with chloroquine was 5.3 years. Presenting visual acuity showed
2(14%) cases of bilateral blindness(VA<3/60 in both eyes); 5(35.7%) cases of
uniocular blindness; three cases of bilateral low vision(VA worse than 6/18 but
better than 3/60). Anterior segment examination showed abnormal sluggish
pupillary reaction in those with severe affectation. Dilated fundoscopy showed
features ranging from mild macular pigmentary changes and bulls eye maculopathy
to overt extensive retinal degeneration involving the posterior pole, attenuation
of retinal vessels, optic atrophy, and beaten bronze appearance of atrophic
maculopathy.ConclusionChloroquine retinopathy is not uncommon in Ibadan,
Sub-Sahara Africa. Bulls eye maculopathy, extensive retinal, and macular
degeneration with optic atrophy are the main presentations. Public health
education is imperative.Eye advance online publication, 2 October 2015;

PMID: 26427986   [PubMed - as supplied by publisher]

5. Eye (Lond). 2015 Oct 2. doi: 10.1038/eye.2015.153. [Epub ahead of print]

New ideas for glaucoma.

Lotery A(1).

Author information: 
(1)Faculty of Medicine, Division of Neurosciences, University of Southampton,
Southampton General Hospital, Southampton, UK.

PMID: 26427985   [PubMed - as supplied by publisher]

6. Eye (Lond). 2015 Oct 2. doi: 10.1038/eye.2015.179. [Epub ahead of print]

Conservative treatment of retinoblastoma: a prospective phase II randomized trial
of neoadjuvant chemotherapy followed by local treatments and chemothermotherapy.

Lumbroso-Le Rouic L(1), Aerts I(2), Hajage D(3), Lévy-Gabriel C(1), Savignoni
A(3), Algret N(3), Cassoux N(1), Bertozzi AI(4), Esteve M(5), Doz F(2,)(6),
Desjardins L(1).

Author information: 
(1)Department of Ocular Oncology, Institut Curie, Paris, France. (2)Department of
Pediatric, Adolescent and Young Adults Oncology, Institut Curie, Paris, France.
(3)Department of Biostatistics, Institut Curie, Paris, France. (4)Department of
Pediatric Oncology, CHU Toulouse, Hôpital des Enfants, Toulouse, France.
(5)Department of Anaesthesiology, Institut Cure, Paris, France. (6)University
Paris Descartes, Sorbonne Paris Cité, Paris, France.

PurposeIntraocular retinoblastoma treatments often combine chemotherapy and focal
treatments. A first prospective protocol of conservative treatments in our
institution showed the efficacy of the use of two courses of chemoreduction with 
etoposide and carboplatin, followed by chemothermotherapy using carboplatin as a 
single agent and diode laser. In order to decrease the possible long-term
toxicity of chemotherapy due to etoposide, a randomized neoadjuvant phase II
protocol was conducted using vincristine-carboplatin vs
etoposide-carboplatin.Patients and methodsThe study was proposed when initial
tumor characteristics did not allow front-line local treatments. Patients
included in this phase II noncomparative randomized study of neoadjuvant
chemotherapy received vincristin-carboplatin (new arm) vs etoposide-carboplatin
(our reference arm). They were subsequently treated by local treatments and
chemothermotherapy. Primary end point was the need for secondary enucleation or
external beam radiotherapy (EBRT) not exceeding 40% at 2 years.ResultsA total of 
65 eyes in 55 children were included in the study (May 2004 to August 2009). Of
these, 32 eyes (27 children) were treated in the arm etoposide-carboplatin and 33
eyes (28 children) in the arm vincristin-carboplatin. At 2 years after treatment,
23/33 (69.7%) eyes were treated and salvaged without EBRT or enucleation in the
arm vincristin-carboplatin and 26/32 (81.2%) in the arm
etoposide-carboplatin.ConclusionEven if the two treatment arms could be
considered as sufficiently active according to the study decision rules,
neoadjuvant chemotherapy by two cycles of vincristine-carboplatin followed by
chemothermotherapy appear to offer less optimal local control than the
etoposide-carboplatin combination.Eye advance online publication, 2 October 2015;

PMID: 26427984   [PubMed - as supplied by publisher]

7. Eye (Lond). 2015 Sep 25. doi: 10.1038/eye.2015.166. [Epub ahead of print]

Retinal nerve fiber layer thickness in prematurity is correlated with stage of
retinopathy of prematurity.

Park KA(1), Oh SY(1).

Author information: 
(1)Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Republic of Korea.

PurposeTo compare retinal nerve fiber layer (RNFL) thickness profiles between
preterm and full-term children and to investigate factors affecting the RNFL
distribution in preterm children.MethodsWe performed Spectral domain optical
coherence tomography (SD-OCT) peripapillary RNFL circular scan centered on the
optic disc in 50 premature and 58 full-term children. RNFL thickness profiles
were compared between preterm and full-term children using a linear regression
model. Among preterm patients in this study, 20 patients previously received
laser treatment for severe retinopathy of prematurity (ROP).ResultsGlobal
average, nasal, and superior disc RNFL thickness profiles were significantly
smaller in preterm children (92.70±16.57 μm, 56.02±17.04 μm, and 108.74±27.36 μm,
respectively) compared with full-term children (101.63±9.21 μm, P=0.006,
69.14±14.15 μm, P<0.001, and superior, 129.11±18.14 μm, P<0.001, respectively).
Multivariable analysis revealed that ROP stage was inversely correlated with
nasal RNFL thickness (P=0.010).ConclusionsOur SD-OCT data demonstrate decreased
global average, nasal, and superior disc RNFL thicknesses in preterm children.
ROP stage was inversely correlated with nasal RNFL thickness. Further studies are
needed to better understand the association between these structural changes and 
visual functions in preterm children.Eye advance online publication, 25 September
2015; doi:10.1038/eye.2015.166.

PMID: 26403327   [PubMed - as supplied by publisher]

8. Eye (Lond). 2015 Sep 25. doi: 10.1038/eye.2015.178. [Epub ahead of print]

Spectral domain ocular coherence tomography findings pre- and post vitrectomy
with fibrovascular membrane delamination for proliferative diabetic retinopathy.

Dooley I(1), Laviers H(1), Papavasileiou E(1), Mckechnie C(1), Zambarakji H(1).

Author information: 
(1)Barts Health; Whipps Cross University Hospital, London, UK.

PurposeTo describe the intraretinal microstructure using serial spectral domain
optical coherence tomography (SD-OCT) preceding and following pars plana
vitrectomy and delamination of fibrovascular membranes in patients with
proliferative diabetic retinopathy (PDR).MethodsThis retrospective,
interventional case series includes 28 eyes. Outcome measures included LogMAR
distance best-corrected visual acuity (BCVA), SD-OCT integrity of photoreceptor
inner and outer segments junction (IS/OS), and integrity of external limiting
membrane (ELM).ResultsPre-operative central macular thickness (CMT) was
significantly correlated with the final post-operative LogMAR BCVA (Pearson's
coefficient r=0.89; P=0.001). The eyes were categorised into three groups based
on post-operative IS/OS integrity (group 0: IS/OS intact; group 1: IS/OS
irregular but not completely disrupted; group 2: IS/OS completely disrupted).
Mean BCVA improved significantly in group 0 (n=9) from 1.13±0.75 preoperatively
to 0.34±0.21 (Student's t-test: P=0.06), in group 1 (n=10) the BCVA improved from
0.88±0.56 to 0.58±0.31 (Student's t-test: P=0.053) and in group 2 (n=9) the BCVA 
improved from 1.64±0.53 to 1.53±0.75 (Student's t-test: P=0.652).IS/OS integrity 
and ELM integrity at 3 months post operatively, were significantly and positively
correlated with final BCVA (Pearson's coefficient: r=0.83, P<0.001 and r=0.72,
P<0.001, respectively).ConclusionsPre-operative CMT and post-operative disruption
of the IS/OS and ELM are useful prognostic indicators in fibrovascular
delamination surgery for patients with PDR.Eye advance online publication, 25
September 2015; doi:10.1038/eye.2015.178.

PMID: 26403326   [PubMed - as supplied by publisher]

9. Eye (Lond). 2015 Sep 18. doi: 10.1038/eye.2015.181. [Epub ahead of print]

Horner's syndrome in patients admitted to the intensive care unit that have
undergone central venous catheterization: a prospective study.

Butty Z(1), Gopwani J(1,)(2), Mehta S(3), Margolin E(1,)(3).

Author information: 
(1)Department of Ophthalmology and Vision Sciences, University of Toronto,
Toronto, Ontario, Canada. (2)Department of Ophthalmology, University of West
Indies, Kingston, Jamaica. (3)Department of Medicine, University of Toronto,
Toronto, Ontario, Canada.

PurposeCentral venous catheterization (CVC) is estimated to be performed in
millions of patients per year. Swan-Ganz catheters used for CVC are most often
inserted into the internal jugular vein and during this procedure they may come
into contact with the sympathetic chain. This study aims to determine the
incidence of Horner's syndrome in patients admitted to intensive care unit that
have undergone internal jugular CVC insertion during their admission and to
determine whether ultrasonography-assisted insertion has decreased the frequency 
of this complication.Patients and methodsA total of 100 prospective patients
admitted to the ICU were examined for the presence of anisocoria and ptosis after
undergoing recent CVC. Presence of Horner's syndrome was confirmed by testing
with 0.5% apraclonidine and looking for the reversal of
anisocoria.ResultsFrequency of Horner's syndrome after CVC was 2% in a sample of 
100 prospectively examined patients.ConclusionHorner's syndrome remains a
relatively rare but definitive complication of CVC. ICU physicians should be
educated about its existence and prevalence and ophthalmologists should inquire
about any history of ICU admission necessitating CVC insertion in any patient
presenting with Horner's syndrome.Eye advance online publication, 18 September
2015; doi:10.1038/eye.2015.181.

PMID: 26381100   [PubMed - as supplied by publisher]

10. Eye (Lond). 2015 Sep 18. doi: 10.1038/eye.2015.167. [Epub ahead of print]

Understanding the patient's lived experience of neovascular age-related macular
degeneration: a qualitative study.

McCloud C(1), Lake S(2).

Author information: 
(1)Faculty of Medicine, Nursing and Health Science, Flinders University, Bedford 
Park, South Australia, Australia. (2)Flinders Medical Centre, Adelaide, South
Australia, Australia.

PurposeIn industrialised populations age-related macular degeneration (ARMD) is
the leading cause of visual disability of the elderly. Successful new treatment
with anti-endothelial growth factors for neovascular-classified ARMD has led to a
divergence in treatment and experiences of people ARMD. This study aimed to
understand the participant's experience of neovascular ARMD, including ongoing
treatment with anti-vascular endothelial growth factor.MethodsTwenty-five
participants from one clinical site were qualitatively interviewed to elicit
their experiences of treatment for neovascular ARMD.ResultsTwo major themes were 
identified. A life negotiated by neovascular ARMD captures the participants'
experience of living with the condition and treatment regime for neovascular
ARMD. The second major theme: Uncertainty displayed their appraisal of life,
treatment and their perceived future.ConclusionsAnxieties concerning the
injections, new limitations to lifestyles, and an uncertain future all emerged
from the data analysis. However, thankfulness for the treatment, the importance
of familiar patterns in treatments and recovery and a guarded optimism also
emerged. Knowledge of the experiences, anxieties and concerns of this patient
population can be used to inform clinical practice and lead to patient-centred
care.Eye advance online publication, 18 September 2015; doi:10.1038/eye.2015.167.

PMID: 26381099   [PubMed - as supplied by publisher]

11. Eye (Lond). 2015 Sep 18. doi: 10.1038/eye.2015.177. [Epub ahead of print]

Associations of FPG, A1C and disease duration with protein markers of oxidative
damage and antioxidative defense in type 2 diabetes and diabetic retinopathy.

Reddy VS(1), Agrawal P(1,)(2), Sethi S(3), Gupta N(3), Garg R(1), Madaan H(1),
Kumar V(1).

Author information: 
(1)Department of Biochemistry, BPS Government Medical College, Sonepat, India.
(2)Department of Biochemistry, Dr. BSA Medical College & Hospital, Delhi, India. 
(3)Department of Ophthalmology, BPS Government Medical College, Sonepat, India.

PurposeTo investigate the role of protein oxidative damage and antioxidant
defense in relationship to hyperglycemia measured as fasting plasma glucose
(FPG), glycated hemoglobin (A1C), and duration of disease in type 2 diabetes
mellitus (DM) and diabetic retinopathy (DR).MethodsThis study recruited 23
non-diabetic subjects, 16 DM patients without any complications and 18 DR
patients. The serum ischemia modified albumin (IMA) and glutathione (GSH) levels 
were measured. The IMA results were corrected for serum albumin. Between-group
differences were studied by analysis of variance and between-variable
associations were studied by Spearman's and partial correlations.ResultsIMA and
cIMA values were elevated, whereas GSH was decreased in both patient groups vs
controls (P<0.05), and the increase in IMA formation is not related to serum
albumin changes. DR patients have much severe oxidative stress (OS) status with
high IMA and cIMA, and low GSH than in the DM group (P<0.05). Both FPG and A1C
levels were positively associated with IMA in DM group, while in the DR group,
duration of disease too had a positive association with IMA. The antioxidant GSH 
had negative correlations with FPG (r=-0.52, P=0.02) and IMA (r=-0.49, P=0.03) in
the DR group. Partial correlation analyses predicted mutual or independent
associations among parameters.ConclusionsSevere OS in DR has been associated with
increased FPG, A1C, and disease duration. Both hyperglycemia and elevated
oxidative damage detected as IMA are collectively associated with depleted GSH
status. Our study unravels the need for monitoring of OS in addition to standard 
glycemic management in DR.Eye advance online publication, 18 September 2015;

PMID: 26381098   [PubMed - as supplied by publisher]

12. Eye (Lond). 2015 Sep 18. doi: 10.1038/eye.2015.173. [Epub ahead of print]

Incidence and risk factors for traumatic intraocular pressure elevation and
traumatic glaucoma after open-globe injury.

Bojikian KD(1), Stein AL(1), Slabaugh MA(1), Chen PP(1).

Author information: 
(1)Department of Ophthalmology, University of Washington, Seattle, WA, USA.

PurposeTo examine traumatic intraocular pressure (IOP) elevation and glaucoma
after open-globe injury.DesignRetrospective, observational case
series.MethodsReview of patients with open-globe repair at the University of
Washington from May 1997 through July 2010. Traumatic IOP elevation and glaucoma 
were defined respectively as intraocular pressure (IOP) ≥22 mm Hg at >1 visit or 
need for glaucoma medication, and long-term (at least 3 months) glaucoma
medication use or glaucoma surgery.ResultsWe included 515 eyes (515 patients).
The mean follow-up was 12.6±20.1 months. One hundred twenty eyes (23.3%)
developed traumatic IOP elevation, of which 32 (6.2%) developed glaucoma; six
eyes (1.2%) required glaucoma surgery. The mean time to development of traumatic 
IOP elevation was 1.5±3.4 months (range 1 day to 2 years). Kaplan-Meier 6- and
12-month estimates for development of traumatic IOP elevation were 27.2 and
32.4%, respectively, and for development of traumatic glaucoma were 7.1 and
11.0%, respectively. Multivariate regression revealed associations between
traumatic IOP elevation and older age, and traumatic glaucoma and prior
penetrating keratoplasty, initial vitreous hemorrhage, Zone II injury, and
penetrating keratoplasty after open-globe repair. Traumatic glaucoma was
controlled (IOP <22 mm Hg) in 78.1% of eyes at final follow-up, with mean IOP of 
18.2 mm Hg on 1.7 medications.ConclusionsTraumatic IOP elevation and glaucoma
were common after visually salvageable open-globe injury. Most cases developed
within 6 months, although longer follow-up remains important for case detection. 
Penetrating keratoplasty before or after repair, and vitreous hemorrhage were
notable risk factors.Eye advance online publication, 18 September 2015;

PMID: 26381097   [PubMed - as supplied by publisher]

13. Eye (Lond). 2015 Sep 18. doi: 10.1038/eye.2015.176. [Epub ahead of print]

Intravitreal bevacizumab for choroidal metastases: the key to efficacy is
simultaneous administration of systemic therapy.

Singh N(1), Bansal R(2), Behera D(1), Gupta A(2).

Author information: 
(1)Department of Pulmonary Medicine, Postgraduate Institute of Medical Education 
and Research (PGIMER), Chandigarh, India. (2)Department of Ophthalmology,
Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh,

PMID: 26381096   [PubMed - as supplied by publisher]

14. Eye (Lond). 2015 Sep 18. doi: 10.1038/eye.2015.174. [Epub ahead of print]

Comment on 'Failure of intravitreal bevacizumab in the treatment of choroidal

Kourie HR(1), Antoun J(1), Kattan J(1).

Author information: 
(1)Faculty of medicine, Saint Joseph University Hematology-Oncology, Beirut,

PMID: 26381095   [PubMed - as supplied by publisher]

15. Eye (Lond). 2015 Sep 18. doi: 10.1038/eye.2015.180. [Epub ahead of print]

Optical coherence tomographic angiography shows reduced deep capillary flow in
paracentral acute middle maculopathy.

Dansingani KK(1,)(2,)(3), Inoue M(1,)(2), Engelbert M(1,)(2,)(4), Freund

Author information: 
(1)Vitreous Retina Macula Consultants of New York, New York, New York, USA.
(2)LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat
Hospital, New York, New York, USA. (3)Moorfields Eye Hospital, London, UK.
(4)Department of Ophthalmology, New York University School of Medicine, New York,
New York, USA. (5)Department of Ophthalmology, North-Shore Long Island Jewish
Health System, Manhasset, New York, USA.

IntroductionParacentral acute middle maculopathy (PAMM) has been described as an 
ischemic lesion of the middle retinal layers with a characteristic lamellar
hyper-reflective placoid appearance in the acute phase and thinning of the
involved retinal layers in the chronic phase. Optical coherence tomographic
angiography (OCTA) is a novel and non-invasive technique for imaging retinal
capillary vasculature with en face segmentation capabilities.MethodCase series.
We describe two patients with PAMM who underwent clinical examination and
multimodal imaging including OCTA.ResultsIn the first patient, who presented with
PAMM secondary to acute cilioretinal artery occlusion, OCTA demonstrated
reduction in flow in the deep capillary plexus (DCP). One month later, OCTA
revealed a flow void due to thinning of the GCL, INL, and OPL and paradoxical
apparent ONL thickening. Similar findings of focal retinal lamellar ectopia were 
seen in the second patient, who had an incidentally detected chronic PAMM
lesion.ConclusionsOCTA images the superficial and deep capillary plexi
independently. PAMM is characterized by acute and chronic attenuation of the DCP 
flow signature. Focal lamellar ectopia in PAMM is discussed.Eye advance online
publication, 18 September 2015; doi:10.1038/eye.2015.180.

PMID: 26381094   [PubMed - as supplied by publisher]

16. Eye (Lond). 2015 Sep 18. doi: 10.1038/eye.2015.172. [Epub ahead of print]

In vivo confocal microscopy of early corneal epithelial recovery in patients with
chemical injury.

Xiang J(1), Le Q(1,)(2,)(3), Li Y(1,)(3), Xu J(1,)(3).

Author information: 
(1)Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai,
China. (2)Research Center, Eye & ENT Hospital of Fudan University, Shanghai,
China. (3)Myopia Key Laboratory of Ministry of Health, Eye & ENT Hospital of
Fudan University, Shanghai, China.

PurposeTo investigate the early recovery of corneal epithelium in patients with
chemical injuries by the application of in vivo laser scanning confocal
microscopy (LSCM).MethodsLSCM was performed on 26 eyes of 18 consecutive patients
at 1, 2, and 3 months post injury. The morphology of central corneal epithelium
and limbus was evaluated. Analysis was performed to compare the densities of
corneal apical surface cells (ASCs) and basal epithelial cells (BECs) among
different injury severity and time points after injury. The comparisons were also
made on inflammatory cells (ICs) and dendritic cells (DCs) infiltrating at the
limbus. Moreover, the presence rate of palisades of Vogt (POV) was analyzed at 3 
months post injury.ResultsCorneal re-epithelialization was found within 3 months 
post injury in all eyes, except that persistent epithelium defect was identified 
in grade IV injured eyes even at 3 months after injury. The injury severity had a
significantly negative correlation with the densities of ASCs. However, it had no
relationship with the densities of BECs. The density of ICs at the limbus
decreased significantly with the prolongation of follow-up, except in the grade I
injured eyes. The presence rate of POV also had a significantly negative
correlation with injury severity.ConclusionEpithelial recovery after chemical
injury varied in cellular morphology and the densities of ASCs among eyes with
different injury severity. The presence rates of POV decreased with the
aggravation of injury. LSCM is a feasible method for observing the early recovery
of corneal epithelium in patients with chemical injuries.Eye advance online
publication, 18 September 2015; doi:10.1038/eye.2015.172.

PMID: 26381093   [PubMed - as supplied by publisher]

17. Eye (Lond). 2015 Sep 11. doi: 10.1038/eye.2015.168. [Epub ahead of print]

Comment on 'The Eye Phone Study: reliability and accuracy of assessing Snellen
visual acuity using smartphone technology'.

Rodríguez-Vallejo M(1).

Author information: 
(1)Qvision, Unidad de Oftalmología Vithas Hospital Virgen del Mar, Almería,

PMID: 26358236   [PubMed - as supplied by publisher]

18. Eye (Lond). 2015 Sep 11. doi: 10.1038/eye.2015.155. [Epub ahead of print]

A novel eye drop application monitor to assess patient compliance with a
prescribed regimen: a pilot study.

Eaton AM(1,)(2), Gordon GM(1,)(2,)(3), Konowal A(4), Allen A(4), Allen M(4),
Sgarlata A(1), Gao G(1,)(2), Wafapoor H(1,)(2), Avery RL(2,)(3).

Author information: 
(1)Retina Health Center, Fort Myers, FL, USA. (2)EDIT Systems Inc., Fort Myers,
FL, USA. (3)California Retina Consultants, Santa Barbara, CA, USA. (4)Konowal
Vision Center, Fort Myers, FL, USA.

PurposeTo assess the ability of a novel imaging device to allow physicians to
personalize therapeutic regimens based on objective patient drop administration
data.MethodsA novel imaging system was used to record video of the drop technique
of subjects in clinic (n=25) or at home (n=17) for 1 week. Video assessment by a 
reading center was compared with patient reporting and their prescribed regimen
with respect to how many drops were applied and how many landed in the
eye.ResultsReading center assessment of both drops dispensed and drops landing in
the eye was significantly different from the prescribed regimen in the clinic
(Pd=0.005, Pi<0.001, respectively) and at-home arms (Pd=0.003, Pi<0.001,
respectively).ConclusionsThis imaging system is a powerful tool to help
physicians tailor patient therapy more accurately, to help researchers evaluate
new drop therapies with objective rather than subjective data, and to potentially
facilitate better patient training for improved drug delivery.Eye advance online 
publication, 11 September 2015; doi:10.1038/eye.2015.155.

PMID: 26358235   [PubMed - as supplied by publisher]

19. Eye (Lond). 2015 Sep 11. doi: 10.1038/eye.2015.169. [Epub ahead of print]

Response to: 'Comment on The Eye Phone Study: reliability and accuracy of
assessing Snellen visual acuity using smartphone technology'.

Perera C(1), Chakrabarti R(2).

Author information: 
(1)Department of Ophthalmology, Fremantle Hospital, Fremantle, Western Australia,
Australia. (2)Department of Ophthalmology, Centre for Eye Research Australia,
University of Melbourne, Melbourne, Victoria, Australia.

PMID: 26358234   [PubMed - as supplied by publisher]

20. Eye (Lond). 2015 Sep;29(9):1240. doi: 10.1038/eye.2015.145.

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

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

PMCID: PMC4565950
PMID: 26353919   [PubMed - in process]

21. Eye (Lond). 2015 Sep 4. doi: 10.1038/eye.2015.163. [Epub ahead of print]

Outcomes of combined phacoemulsification and deep sclerectomy: a 10-year UK
single-centre study.

Mercieca K(1), Shevade B(2), Anand N(1,)(2).

Author information: 
(1)Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK. (2)Calderdale 
and Huddersfield NHS Trust, Huddersfield, UK.

PurposeTo report the outcomes of combined phacoemulsification and -deep
sclerectomy (phaco-DS) from a single UK centre over a 10-year
period.MethodsRetrospective analysis of phaco-DS data extracted from an ongoing
glaucoma surgery database within Calderdale and Huddersfield NHS Trust. Two
hundred and ninety-six eyes of 282 patients were included. Data included patient 
demographics, pre- and postoperative intraocular pressure (IOP), use of mitomycin
C (MMC), spacer device implantation, and follow-up details including surgical
success rates. IOP success criteria were: (A) IOP <19 mm Hg and/or 20% decrease
from baseline and (B) IOP <16 mm Hg and/or 30% drop from baseline.ResultsMean
follow-up was 63.5±35.3 months. MMC was applied in 145 eyes (49%). Kaplan-Meier
success rates in all eyes for criteria A were 89.1% and 80% with glaucoma
medications (qualified success) and 81.2% and 68.3% without medications
(unqualified success) at 2 and 5 years, respectively. Qualified success for
criteria B was 72.4 and 61.4% and unqualified rates were 67.2 and 55.2% for the
same time periods. Repeated-measures ANOVA showed significantly lower IOP in the 
phaco-DS with MMC group up to 3 years postoperatively (P=0.002). Cox's
proportional hazards for criteria B, however, showed no significant effect of MMC
application in the long term (P=0.2). Increasing age and laser goniopuncture were
positively associated with success, whereas the absence of spacer devices was
negatively associated. At last follow-up, 20% of eyes were on glaucoma
medications. Complication rates were low with hypotony rates of
0.68%.ConclusionsThis study confirms the long-term safety and efficacy of
phaco-DS as a primary glaucoma procedure.Eye advance online publication, 4
September 2015; doi:10.1038/eye.2015.163.

PMID: 26337945   [PubMed - as supplied by publisher]

22. Eye (Lond). 2015 Sep 4. doi: 10.1038/eye.2015.150. [Epub ahead of print]

High-dose ranibizumab monotherapy for neovascular polypoidal choroidal
vasculopathy in a predominantly non-Asian population.

Marcus DM(1), Singh H(1), Fechter CM(2), Chamberlain DP(3); Medscape.

Author information: 
(1)Southeast Retina Center, Augusta, GA, USA. (2)Mercer University School of
Medicine, Macon, GA, USA. (3)Harvard University, Boston, MA, USA.

PurposeTo determine safety and efficacy of intravitreal high-dose ranibizumab in 
the treatment of active neovascular polypoidal choroidal vasculopathy
(PCV).MethodsIn this Phase I/II, single-center, randomized, controlled,
double-masked study, predominantly non-Asian, previously treated or
treatment-naive, male and female adult patients were randomized to receive
high-dose (1.0/0.1 ml or 2.0 mg/0.05 ml; n=15) or standard-dose (0.5 mg/0.05 ml; 
n=5) ranibizumab in 3 monthly loading doses, followed by 9 months of
criteria-based, as-needed retreatment. Safety was evaluated by a descriptive
analysis of all non-serious and serious adverse events, angiographic assessments,
physical examinations, vital signs, ocular examinations, and visual acuity
measurements. Visual acuity and anatomic outcomes are described for the high-dose
group.ResultsTwenty patients (aged 35-76 years; 8 Black, 11 White, 1 Asian) were 
enrolled. At baseline, in the high-dose group, mean best-corrected visual acuity 
(BCVA) was 63.5 letters (Snellen equivalent ~20/50), and mean baseline central
foveal thickness (CFT) was 253.7 μm. High-dose ranibizumab was generally well
tolerated without evidence of ocular or systemic severe adverse events, including
arterial thromboembolic events. At month 12, in the high-dose group, the mean
overall change from baseline in BCVA was +6.7 letters and in CFT was
-49.7 μm.ConclusionHigh-dose ranibizumab monotherapy is safe and efficacious for 
treating patients with PCV.Eye advance online publication, 4 September 2015;

PMID: 26337944   [PubMed - as supplied by publisher]

23. Eye (Lond). 2015 Sep 4. doi: 10.1038/eye.2015.158. [Epub ahead of print]

How strong is the relationship between glaucoma, the retinal nerve fibre layer,
and neurodegenerative diseases such as Alzheimer's disease and multiple

Jones-Odeh E(1), Hammond CJ(1,)(2).

Author information: 
(1)Department of Ophthalmology, King's College London, London, UK. (2)Department 
of Twin Research and Genetic Epidemiology, King's College London, London, UK.

Glaucoma is a neurodegenerative disorder with established relationships with
ocular structures such as the retinal nerve fibre layer (RNFL) and the ganglion
cell layer (GCL). Ocular imaging techniques such as optical coherence tomography 
(OCT) allow for quantitative measurement of these structures. OCT has been used
in the monitoring of glaucoma, as well as investigating other neurodegenerative
conditions such as Alzheimer's disease (AD) and multiple sclerosis (MS). In this 
review, we highlight the association between these disorders and ocular
structures (RNFL and GCL), examining their usefulness as biomarkers of
neurodegeneration. The average RNFL thickness loss in patients with AD is 11 μm, 
and 7 μm in MS patients. Most of the studies investigating these changes are
cross-sectional. Further longitudinal studies are required to assess sensitivity 
and specificity of these potential ocular biomarkers to neurodegenerative disease
progression.Eye advance online publication, 4 September 2015;

PMID: 26337943   [PubMed - as supplied by publisher]