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American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:25 +0100

(Source: American Journal of Ophthalmology)

Scientific Referees 2009

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

The Editorial Board of the american journal of ophthalmology gratefully acknowledges the contributions of these scientific reviewers to the integrity, accuracy, and quality of the journal. These reviewers generously contributed their knowledge, expertise, and time to review and evaluate the suitability of manuscripts for publication in the journal during the year 2009. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

Media Type: Textbook Target Audience: Neuro-ophthalmologist (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

Media Type: Textbook Target Audience: Ophthalmology Residents, Attending Ophthalmologists, and Emergency Room Physicians (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

Media Type: Textbook Synopsis: This book is an exquisitely well-written review of the pathogenesis, epidemiology, and natural history of retinal detachment, as well as the principles of retinal detachment repair. The authors offer a carefully considered synopsis of the literature enriched with pearls from their vast clinical and surgical experience. Particularly impressive is the concise, rational and impartial discussion of the several vantage points on methods of retinal detachment repair. Ophthalmology trainees and practicing ophthalmologists alike will enjoy and treasure this textbook. (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

The AJO encourages authors to report the visual acuity in the manuscript using the same nomenclature that was used in gathering the data provided they were recorded in one of the methods listed here. This table of equivalent visual acuities is provided to the readers as an aid to interpret visual acuity findings in familiar units. (Source: American Journal of Ophthalmology)

Spontaneous Corneal Clearance Despite Graft Detachment in Descemet Membrane Endothelial Keratoplasty

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

We read with interest the article by Balachandran and associates reporting on 2 cases of spontaneous corneal clearance despite graft detachment in Descemet membrane endothelial keratoplasty. In our experience, we also had a case whereby an 86-year-old man with cataract and a distant uncorrected visual acuity (UCVA) of 6/60 in his right eye underwent extracapsular cataract extraction (ECCE) in June 2008. During the procedure, the surgeon accidentally removed almost the entire central Descemet membrane, leaving a 2-mm peripheral rim of Descemet membrane. Postoperatively, there was diffuse stromal edema with hand-movement vision. We managed him conservatively in view of the fact that his general health and age did not allow him to undergo further operation under general anesthesia. (Source: A...

Reply

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

I thank Dr Gosala for his letter. He first suggests that differences in iris stroma between angle-closure and other eyes might be an effect of acute high intraocular pressure (IOP) leading to “damage to the stroma” rather than a pre-existing risk factor. This is not compatible with our findings, since most of the angle-closure eyes in which we found lower iris volume loss with pupil dilation had never had an acute attack. The general level of IOP in the angle-closure eyes was similar to the open-angle glaucoma eyes in our studies—including adjustment for other features such as medical eyedrop treatment, length of disease, and surgery. To show that the feature of lower iris volume loss is truly predictive (hence, “causative”), we and others are carrying out prospective studies of ...

Angle-Closure Glaucoma—Simpler Answers to Complex Mechanisms

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

The article “Angle-closure glaucoma–Simpler answers to complex mechanisms: LXVI Edward Jackson Memorial Lecture” by Harry A Quigley introduces a new concept of dynamic physiological features precipitating acute angle closure in susceptible individuals with static anatomic factors. This answers many issues related to the pathogenesis of glaucoma in general and angle-closure glaucoma in particular. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

Imaging instruments are a powerful tool to assist clinicians in the diagnosis and management of glaucoma. However, image quality is an important variance component that can affect the outcomes of any imaging device, including Stratus OCT (Carl Zeiss Meditec, Dublin, California, USA). Based on our findings and the findings from other groups, signal strength can influence measurements' accuracy and reliability. Therefore, scan quality should always be assessed before interpreting Stratus OCT results for clinical management decisions. (Source: American Journal of Ophthalmology)

Stratus OCT Signal Strength and Reliability of Retinal Nerve Fiber Layer Measurements

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

The recent article by Vizzeri and associates makes an interesting contribution to the emerging literature examining the roles of signal strength and scan misalignment on the reliability of retinal nerve fibre layer (RNFL) measurements using optical coherence tomography (OCT). In this retrospective study, the authors assessed the relationship between signal strength and RNFL measurements by comparing repeat and baseline Stratus OCT (Carl Zeiss Meditec, Dublin, California, USA) scans. Influences from vertical and horizontal scan alignment on RNFL measurements also was assessed. The authors reported a larger variation in RNFL measurements between scans at different visits than on repeat scans at the same visit, and also reported significant differences (from baseline) in quadrant-specific RNF...

Reply

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

We would like to thank Dr Teus for his interest in and comments on our article, entitled “Increased likelihood of glaucoma at the same screening intraocular pressure in subjects with pseudoexfoliation: the Thessaloniki Eye Study.” We agree with Dr Teus that population-based data on pseudoexfoliation (PEX) and pseudoexfoliative glaucoma (PEXG) are limited and therefore needed. In our opinion, the considerably high prevalence of PEX and PEXG found in the Thessaloniki Eye Study (TES) provides a dataset suitable for comparison of clinical characteristics between primary open-angle glaucoma (POAG) and PEXG. In the present manuscript we reported that for intraocular pressure (IOP) level > 20 mm Hg, the proportion with glaucoma increased highly in subjects both with and without PEX, while it ...

Increased Likelihood of Glaucoma at the Same Intraocular Pressure in Subjects With Pseudoexfoliation

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

We read, with great interest, the paper by Topouzis and associates. The authors should be congratulated for their work, because population-based studies are needed to provide accurate information about the prevalence of any disease in the general population. In this sense, the conclusions the authors reach about the prevalence of pseudoexfoliation (PEX), pseudoexfoliative glaucoma (PEXG), and primary open-angle glaucoma (POAG) in the Greek population are sound. Nevertheless, Topouzis and associates also analyze the influence of IOP in the development of glaucoma. For this kind of analysis, it is mandatory to evaluate the untreated IOP of the population studied. In fact, this is what the authors do, but as the prevalence of both PEXG and POAG in the general population is relatively low, and...

Reply

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

We appreciate the comments by Dr Nazm and associates about our article, which looked at the outcome of raised intraocular pressure in uveitic eyes with and without a corticosteroid-induced hypertensive response. (Source: American Journal of Ophthalmology)

Outcome of Raised Intraocular Pressure in Uveitic Eyes With and Without a Corticosteroid-Induced Hypertensive Response

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:24 +0100

We read with great interest the recently published article “Outcome of raised intraocular pressure in uveitic eyes with and without a corticosteroid-induced hypertensive response” by Sallam and associates. We would like to highlight the following points. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:23 +0100

In this letter, we reply to the issues presented by Dr Ali Poostchi and associates in their correspondence to the Editor regarding our article. We thank Dr Poostchi and his associates for sharing their findings on the associations between the corneal hysteresis and intraocular pressure. We are in agreement with their explanations that the associations may be related to the measurement of the ocular response analyzer (ORA), which was not considered in our article. We hope this exchange will stimulate further research. (Source: American Journal of Ophthalmology)

Recovery of Corneal Hysteresis After Reduction of Intraocular Pressure in Chronic Primary Angle-Closure Glaucoma

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:23 +0100

We read with interest the paper by Sun and associates, which corroborates prior reports of rises in corneal hysteresis following reductions in intraocular pressure (IOP), but were surprised that they did not consider that the association they found could be related to their method of measurement. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:23 +0100

We thank Dr Pai and associates for their helpful insights regarding testability of visual function tests in preschool-aged children. The Sydney Pediatric Eye Disease Study (SPEDS) corroborates with the testability results from our Strabismus, Amblyopia, and Refractive Error Study (STARS) in many respects, with a few notable small differences. For example, the Singaporean cohort had better logMAR visual acuity (VA) and IOL Master testabilities than the Sydney cohort. In contrast, children in Sydney had better Randot stereoacuity testability than Singaporean children. We agree that these differences can be explained by variability in examiners between the 2 study centers as well as differences in testing protocols and population characteristics. When children in the SPEDS used the electroni...

Testability of Vision and Refraction in Preschoolers

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:23 +0100

Trager and associates recently reported interesting findings from the Strabismus, Amblyopia and Refractive Error Study (STARS) on the testability of vision and refraction in a Singaporean sample of Chinese preschool children, aged 6 to 72 months. The authors correctly indicated that there was a paucity of studies in the literature on the testability of different vision screening modalities in preschool children internationally, and that most publications were based on relatively small sample sizes. This makes it difficult to evaluate the sensitivity, the specificity, and the practical values of some vision testing methods in preschool populations. (Source: American Journal of Ophthalmology)

The Development of Myopia Among Children With Intermittent Exotropia

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:23 +0100

Purpose: To describe the long-term refractive error changes in children diagnosed with intermittent exotropia (IXT) in a defined population.Design: Retrospective, population-based observational study.Methods: Using the resources of the Rochester Epidemiology Project, the medical records of all children ( (Source: American Journal of Ophthalmology)

Pattern Electroretinogram and Psychophysical Tests of Visual Function for Discriminating Between Healthy and Glaucoma Eyes

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:22 +0100

Conclusion: The diagnostic accuracy of the pattern ERG amplitude was similar to that of SAP and SWAP, but somewhat worse than that of FDT. Nevertheless, the pattern ERG may hold some advantage over psychophysical testing because of its largely objective nature. (Source: American Journal of Ophthalmology)

Choroidal Neovascularization in Pathologic Myopia: Intravitreal Ranibizumab Versus Bevacizumab—A Randomized Controlled Trial

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:21 +0100

Conclusion: This randomized clinical study cannot determine a statistically significant difference in anti-VEGF treatment effect between ranibizumab and bevacizumab for the treatment of CNV secondary to pathologic myopia. A larger study is required to determine the relative efficacy and duration of action of these drugs. (Source: American Journal of Ophthalmology)

Primary Retinectomy in Proliferative Vitreoretinopathy

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:21 +0100

Conclusions: Our results show that primary retinectomy without scleral buckling has good anatomic and functional results. (Source: American Journal of Ophthalmology)

Association Between the Efficacy of Photodynamic Therapy and Indocyanine Green Angiography Findings for Central Serous Chorioretinopathy

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:21 +0100

Conclusion: The PDT success rate in eyes with chronic CSC depends on the degree of hyperpermeability on ICGA. PDT is not effective or the recurrence rate is predicted to be high in eyes without intense hyperfluorescence. (Source: American Journal of Ophthalmology)

Viral Retinitis After Intravitreal Triamcinolone Injection in Patients With Predisposing Medical Comorbidities

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:21 +0100

Conclusions: Our high reported incidence for this potentially devastating complication can be attributed to multiple factors, including coexisting medical immunocompromising comorbidities, a higher dose with a longer duration of local immunosuppression in the vitreous, multiple injections, as well as previous viral retinitis. Caution with a high index of clinical suspicion and frequent follow-up is advised in patients receiving IVTA injection with potentially immune-altering conditions, even after apparent immune recovery. (Source: American Journal of Ophthalmology)

Quality of Life in Keratoconus Patients After Penetrating Keratoplasty

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:21 +0100

Conclusion: Despite satisfactory results on visual outcome measures obtained after PK, vision-related QoL in KCN patients remains impaired. (Source: American Journal of Ophthalmology)

Non-Syndromic Supernumerary Caruncles Causing Ocular Irritation After Cataract Surgery: A Critical Review of Caruncular Dysgeneses

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:03 +0100

Conclusions: A literature review confirms that supernumerary (extra) caruncles coexisting with a normal caruncle are always unilateral and unassociated with any other ocular anomalies, as in the current case. They may, however, cause ocular irritation. They must be distinguished from ectopic (topographically displaced) or dysplastic caruncles that are generally bilateral and often associated with ocular adnexal abnormalities or Goldenhar syndrome. Ectopic or dysplastic caruncles, but not supernumerary ones, are characteristically accompanied by plical abnormalities or its absence. Well-documented supernumerary and ectopic caruncles have always been located in the inferior palpebral conjunctiva. (Source: American Journal of Ophthalmology)

Complications and Clinical Outcomes of Descemet Stripping Automated Endothelial Keratoplasty With Intraocular Lens Exchange

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:03 +0100

Conclusions: Concurrent IOL exchange with DSAEK surgery does not increase the dislocation, primary graft failure, or pupillary block rates in the immediate postoperative period. Donor endothelial cell loss in DSAEK was not increased significantly by IOL exchange. Visual acuity was slightly worse after combined surgery than after DSAEK alone. (Source: American Journal of Ophthalmology)

Posterior Vitreous Detachment: Evolution and Complications of Its Early Stages

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:02 +0100

Conclusions: Age-related PVD is an insidious, chronic event that begins in the perifoveal macula and evolves over a prolonged period before vitreopapillary separation. Although asymptomatic in most individuals, its early stages may be complicated by a variety of macular and optic disc pathologic features, determined in part by the size and strength of the residual vitreoretinal adhesion. (Source: American Journal of Ophthalmology)

Study Designs in Epidemiology and Levels of Evidence

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:02 +0100

Facing an enormous influx of information from medical research, clinicians need to differentiate robust study findings from spurious ones and to decide which results they can use with high confidence and which they should be more skeptical about. Epidemiology provides guidelines for critical appraisal of the literature. This series aims to equip clinicians with the basic skills to analyze scientific evidence from the literature and wisely use high-quality evidence to guide their clinical practice while avoiding being misled. (Source: American Journal of Ophthalmology)

Current Research in Biostatistics

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:02 +0100

In the 1950s and '60s, a doctoral student in biostatistics could be reasonably expected to acquire a fairly sophisticated knowledge of the whole field before completing the doctoral dissertation. This knowledge would include the fundamentals of probability and mathematical theory of statistical inference, as well as biostatistics proper—that is, the theory and application of statistics to the life and health sciences. Today, biostatistics has grown to the point that no doctoral student in it can become an expert in all of it. Thus, our ambitious title notwithstanding, we can, in this limited space, only aspire to cover part of the current research in biostatistics. (Source: American Journal of Ophthalmology)

Central Serous Chorioretinopathy: A Personal Perspective

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:02 +0100

Although von Graefe described some of the clinical aspects of “relapsing idiopathic detachment of the macula” as early as 1866, it was more than 100 years later that Maumenee, using fluorescein angioscopy, noted that the detachment of the macula resulted from a leak at the level of the retinal pigment epithelium (RPE). The disorder at that time was commonly referred to as central serous retinopathy. Although numerous articles and name changes have been published in the ophthalmic literature, expanding our knowledge of its cause, clinical manifestations, natural course, and treatment, the pathogenesis of this condition remains poorly understood, little is known about the long-term natural course, and treatment is based on observational, uncontrolled studies. (Source: American Journal of...

Peer Review Should Continue After Publication

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:02 +0100

Most medical journals do not have a mechanism for producing well-written evidence-based medicine on a measured monthly basis. Some published articles are poorly written and some have few usable clinical tidbits. The temperament of different editors and editorial boards may vary from seeking sensational content that may be risky and shortly abandoned to publishing only methodical proven science. In fact, some view journals as a place to deposit only vetted and established work for posterity. The AJO, as do many journals, occasionally publishes controversial or novel topics and may provide an editorial to challenge the content, or offers readers the opportunity to challenge content through the correspondence section. In reality, most peer-reviewed journals seek more trust than debate and see...

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:29 +0100

(Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:29 +0100

Media Type: Textbook Synopsis: This book is an 8th edition of the classic textbook originally published by Drs. Shaffer and Becker in 1961. The goal is “to provide, in one comprehensive volume, information from the clinician's viewpoint” for the management of glaucoma. In a departure from previous editions, several contributors in addition to the principal authors have assisted with 6 of the 39 chapters; nonetheless, the three principal authors succeed in preserving the cohesiveness of the text, sometimes missing in textbooks in which each chapter is authored by different contributors. Becker-Shaffer's Diagnosis and Therapy of the Glaucomas, 8th edition, is effectively illustrated without being overdone and provides an excellent update to the diagnosis and treatment of different glauc...

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:29 +0100

Media Type: Textbook Synopsis: The scope of oculoplastic cosmetic procedures continues to expand in both range and depth of understanding. Pearls and Pitfalls in Cosmetic Oculoplastic Surgery ambitiously reviews many of the most frequently performed oculoplastic, cosmetic procedures through a well-organized compilation of over a hundred and seventy contributions from nearly a hundred authors, detailing favored approaches and “tricks of the trade.” Novices and senior surgeons alike will benefit from the long string of pearls amassed to prevent the most common pitfalls. Although the material is densely presented, chapter brevity makes this an easy pick-up read. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:28 +0100

Media Type: Handbook/textbook Synopsis: Alastair Denniston and Philip Murray have followed up the first edition of the Oxford Handbook of Ophthalmology with an excellent, very thorough handbook that is useful for ophthalmologists at any stage in their training or career. The book has many contributing authors, all of whom are based in the UK. (Source: American Journal of Ophthalmology)

Announcement

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:28 +0100

Marco A. Zarbin, MD, is this year's recipient of the Heed Award. Dr. Zarbin, a previous Heed Fellow, received the award at the annual alumni luncheon of the Society of Heed Fellows during the 2009 American Academy of Ophthalmology Meeting in San Francisco, California. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:28 +0100

Inspired by the encouraging finding reported by his group based on pulse systemic steroid and topical betamethasone therapies, the author drafted the editorial entitled “Acute Management of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis to Minimize Ocular Sequelae” with a single purpose in mind, that is, to call consulting ophthalmologists' attention to take an active role in ameliorating potentially blinding complications during the acute care of patients inflicted with Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN; see the first and the last paragraph of the editorial). This effort is augmented by a new literature revelation indicating that SJS/TEN can be distinguished, clinically, from an often-confusing entity termed erythema multiforme and that promisin...

Systemic and Local Management at the Onset of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis with Ocular Complications

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:28 +0100

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal necrolysis (TEN) are recognized as two of the most devastating ocular surface disorders and are extremely difficult to treat both at the acute and later stages. Massive inflammation on the ocular surface at the acute stage often is uncontrollable. Even after the acute-stage impairments subside, ocular complications such as serious visual impairment with dry eye and keratinization remain at the later stage. Recently, we reported in our retrospective analysis that visual outcomes at the later stage were significantly better in the group receiving topical steroids at the acute stage compared with the no-treatment group (P < .00001). Furthermore, using a prospective study, we confirmed the therapeutic importance of steroid therapy at disease o...

Reliability and Validity of Abbreviated Surveys Derived from the National Eye Institute Visual Function Questionnaire: The Study of Osteoporotic Fractures

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:28 +0100

Conclusions: Both questionnaires showed high reliability across items and validity with respect to clinical markers of eye disease. Future research should compare the properties of these shortened surveys with those of the NEI VFQ-25. (Source: American Journal of Ophthalmology)

Prognostic Factors of Vitreous Hemorrhage Secondary to Exudative Age-Related Macular Degeneration

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:28 +0100

Conclusions: PPV can improve visual acuity in the eyes with VH secondary to AMD, although effectiveness is limited. Medical practitioners should be cautious of the visual prognosis, especially in the cases in which the fellow eye has exudative AMD. (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:27 +0100

Idiopathic Epiretinal Macular Membrane and Cataract Extraction: Combined versus Consecutive Surgery

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:27 +0100

Conclusions: Combined and consecutive surgeries are effective procedures to treat idiopathic ERM. The functional and anatomic results are equivalent in both procedures. (Source: American Journal of Ophthalmology)

Serous Retinal Detachment Associated With Retinal Vein Occlusion

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:27 +0100

Conclusions: In eyes with retinal vein occlusion, a small pointed RD initially developed just beneath the fovea, but subsequently changed into a dome-shaped RD. Based on the findings by OCT, we hypothesize that the foveal architecture, especially that of the Müller cell cone, is involved in the formation of serous RD. (Source: American Journal of Ophthalmology)

Glaucoma Surgery Decreases the Rates of Localized and Global Visual Field Progression

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:27 +0100

Conclusions: Successful IOP reduction after glaucoma surgery greatly reduces both the number of progressing points and the localized and general rates of VF progression. (Source: American Journal of Ophthalmology)

Unfolded Protein Response in Fuchs Endothelial Corneal Dystrophy: A Unifying Pathogenic Pathway?

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:25 +0100

Conclusions: Results of both TEM and immunohistochemistry indicate activation of unfolded protein response in Fuchs dystrophy. Unfolded protein response activation leads to endothelial cell apoptosis in Fuchs dystrophy and may play a central pathogenic role in this disease. (Source: American Journal of Ophthalmology)

HLA Typing in Uveitis: Use and Misuse

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:25 +0100

Conclusions: In general, HLA typing has limited usefulness as a diagnostic test in patients with uveitis. (Source: American Journal of Ophthalmology)

Bayesian Methods for Data Analysis

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:25 +0100

The Bayesian approach to data analysis dates to the Reverend Thomas Bayes, who published the first Bayesian analysis (reprinted in Barnard 1958). Initially, Bayesian computations were difficult except for simple examples, and applications of Bayesian methods were uncommon until Adrian F. M. Smith began to spearhead applications of Bayesian methods to real data. Bayesian applications to science and medicine have exploded in the past 20 years (cf Berger 2000) because of the development of flexible and robust computational algorithms (Markov chain Monte Carlo). (Source: American Journal of Ophthalmology)

Muscle Paths Matter in Strabismus Associated With Axial High Myopia

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:25 +0100

The relationship between high axial myopia and severe strabismus has long been recognized. Our understanding of the pathogenesis of this form of strabismus has, however, evolved tremendously, as illustrated by the paper in this issue by Yamaguchi and associates. Classical concepts of pathogenesis of severe myopic strabismus included supposition that the enlarged, highly myopic globe was gravitationally heavy and would physically sink to the orbital floor, or compress the lateral rectus muscle, causing ischemic paresis resulting in esotropia. These pathophysiologic suppositions provided ready explanations for the typical failure of standard recess/resect strabismus surgery to correct severe strabismus associated with high myopia. In retrospect, these formerly reasonable concepts now seem ou...

On the Nature of, and Response to, Medical Evidence

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:25 +0100

When President Obama announced his support for “evidence-based” medicine, I became very concerned. Might patients think our past medical practices and recommendations were not based on evidence? Recent events have validated my concerns, but for entirely different reasons. Many politicians, patients, and even physicians it appears, completely oppose basing clinical practices on sound evidence! (Source: American Journal of Ophthalmology)

At the Frontier of Vision Research: The National Eye Institute Celebrates 40 Years

American Journal of Ophthalmology — Tue, 12 Jan 2010 16:10:25 +0100

This year marks the fortieth anniversary of the National Eye Institute (NEI), during which we celebrate 4 decades of leadership in basic and clinical science of the eye and vision. The NEI emerged from the National Institute of Neurological Diseases and Blindness in 1968 as the first government organization solely dedicated to research on human visual diseases and disorders. Its establishment was the result of both a Congressional interest and urging by prominent ophthalmologists. (Source: American Journal of Ophthalmology)

Acute Endophthalmitis After Cataract Surgery: 250 Consecutive Cases Treated at a Tertiary Referral Center in the Netherlands

American Journal of Ophthalmology — Tue, 05 Jan 2010 00:00:00 +0100

Conclusions: Treatment outcome after endophthalmitis is highly dependent on the causative organism. Treatment outcomes for gram-negative bacteria and S. aureus may be better than previously reported. Prompt treatment of endophthalmitis remains essential and the role of complete primary vitrectomy remains subject to debate. (Source: American Journal of Ophthalmology)

Comparison of Intravitreal Triamcinolone Acetonide With Photodynamic Therapy and Intravitreal Bevacizumab with Photodynamic Therapy for Retinal Angiomatous Proliferation

American Journal of Ophthalmology — Tue, 05 Jan 2010 00:00:00 +0100

Conclusions: Compared with IVTA plus PDT, IVB plus PDT was significantly more effective in maintaining and improving visual acuity and in reducing the number of treatment for patients with retinal angiomatous proliferation. (Source: American Journal of Ophthalmology)

Protective Effect of Paraoxonase 1 Gene Variant Gln192Arg in Age-Related Macular Degeneration

American Journal of Ophthalmology — Wed, 30 Dec 2009 00:00:00 +0100

Conclusion: We report a weak association of PON1 Leu55Met with an increased risk of wet AMD, replicating previous reports. Our findings indicate a protective role for Gln192Arg, particularly for patients with the wet form. Gln192Glu warrants consideration, as this variant alters the same amino acid as Gln192Arg and was identified only in category 4 AMD patients. We believe that Met127Arg, His155Arg, and Ala252Gly play minor roles in AMD susceptibility because of their limited frequency and/or location within the PON1 gene. The functional and biological mechanism by which Gln192Arg is acting to decrease AMD susceptibility remains to be determined. (Source: American Journal of Ophthalmology)

Paretic Side/Normal Side Ratios of Cross-Sectional Areas of the Superior Oblique Muscle Vary Largely in Idiopathic Superior Oblique Palsy

American Journal of Ophthalmology — Wed, 30 Dec 2009 00:00:00 +0100

Conclusions: The muscle hypoplasia could be defined as such when the paretic side/contralateral side ratios of cross-sectional areas of the superior oblique muscle on magnetic resonance images fell outside the 95% confidence interval of the ratios in normal controls. (Source: American Journal of Ophthalmology)

Retinal Thickness Analysis by Race, Gender, and Age Using Stratus OCT

American Journal of Ophthalmology — Wed, 30 Dec 2009 00:00:00 +0100

Conclusions: There are statistically significant differences in retinal thickness between subjects of different race, gender, and age. When compared to Caucasian and Hispanic subjects, African-American race is a predictor of decreased mean foveal thickness; and male sex (regardless of race) is a significant predictor of increased mean foveal thickness. Mean foveal thickness is similar among diabetics and nondiabetics when data are controlled for age, race, and sex. These results suggest that studies comparing OCT measurements should carefully control for age-based, race-based, and gender-based variations in retinal thickness. (Source: American Journal of Ophthalmology)

One-Year Results of Reduced-Fluence Photodynamic Therapy for Polypoidal Choroidal Vasculopathy

American Journal of Ophthalmology — Wed, 30 Dec 2009 00:00:00 +0100

Conclusions: Reduced-fluence PDT is an effective treatment for PCV and could improve vision even in eyes with VA better than 20/40. (Source: American Journal of Ophthalmology)

Mycophenolate Mofetil for Ocular Inflammation

American Journal of Ophthalmology — Wed, 30 Dec 2009 00:00:00 +0100

Conclusions: Given sufficient time, mycophenolate mofetil was effective in managing ocular inflammation in approximately half of the treated patients. Treatment-limiting side effects were observed in 12% of patients and typically were reversible. (Source: American Journal of Ophthalmology)

Long-term Follow-up of Full Macular Translocation for Choroidal Neovascularization

American Journal of Ophthalmology — Fri, 25 Dec 2009 00:00:00 +0100

Conclusions: Long-term follow-up of full macular translocation showed that the final VA was poor in age-related macular degeneration, but relatively better in myopic CNV. (Source: American Journal of Ophthalmology)

A Simplified Quantitative Method for Assessing Keratoconjunctivitis Sicca From the Sjögren's Syndrome International Registry

American Journal of Ophthalmology — Fri, 25 Dec 2009 00:00:00 +0100

Conclusions: This new method for assessing KCS will become the means for diagnosing the ocular component of SS in future classification criteria. We find 2 forms of KCS whose causes may differ. (Source: American Journal of Ophthalmology)

Wavefront Analysis, Contrast Sensitivity, and Depth of Focus After Cataract Surgery With Aspherical Intraocular Lens Implantation

American Journal of Ophthalmology — Fri, 25 Dec 2009 00:00:00 +0100

Conclusions: Aspherical aberration-free Akreos AO IOL induced significantly less higher-order aberrations and spherical aberration than the Akreos Fit. Contrast sensitivity was better under mesopic conditions with the Akreos AO with similar results of depth of focus. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

(Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

Media Type: Textbook with PDA download Synopsis: The 3rd edition of the comprehensive and concise Massachusetts Eye and Ear Infirmary Illustrated Manual of Ophthalmology is now in print. This 664-page book covers most topics in just the right amount of detail, accompanied by clinical photographs, imaging studies, and illustrations that demonstrate the point. The manual comes with software that can be loaded on either a Windows or Mac operating system to be used on a hand-held device for easy access in the clinic or hospital. Since the original manual was published in 1998, the book has grown in size by about 30% and contains much updated information and many more images than before. It is a handy guide for residents but is also a good reference source for the practicing ophthalmologist. (...

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

Media Type: Textbook Synopsis: Drs. Singh, Damato, Pe'er, Murphree, and Perry have taken their comprehensive text, Clinical Ophthalmic Oncology, and distilled it down to a concise book covering the spectrum of ophthalmic oncologic diseases—Essentials in Ophthalmic Oncology. Together with over 120 authors, they have compiled a useful reference for any ophthalmologist, oncologist, or other physician with an interest in ophthalmic tumors. The text is very readable and has sections covering eyelid tumors, conjunctival and corneal tumors, uveal tumors, retinal tumors, retinoblastoma, and orbital tumors. Each section is broken down into short chapters covering individual groups of conditions, therapies, or other topics in ophthalmic oncology (e.g., epidemiology, cancer biology, and patient co...

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

Media Type: Textbook Synopsis: DSEK surgery has quickly ascended to widespread acceptance as the therapeutic modality of choice for patients with dysfunction of the corneal endothelium. With the near ubiquitous adoption of this procedure has come a renewed interest in this form of endothelial keratoplasty as an alternative to penetrating keratoplasty. A multitude of papers have been published in the past few years on DSEK surgery, however this is the first comprehensive textbook devoted to the subject. DSEK: What You Need to Know About Endothelial Keratoplasty is the cornea surgeon's handbook to DSEK surgery, a timely and excellent addition to the ophthalmic literature. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

We thank Price and Price for their comments on our article on corneal clearance despite graft detachment after Descemet membrane endothelial keratoplasty (DMEK). Since the submission of our article, there have been several other cases with a similar postoperative course, that is, the endothelialization of recipient posterior stroma in the presence of a detached graft (). Although the endothelial cell density is closely monitored in all cases, the postoperative intervals may yet be too short to anticipate on any further increase in cell density, that is, cell counts exceeding 300 to 500 cells/mm2. (Source: American Journal of Ophthalmology)

Spontaneous Corneal Clearance Despite Graft Detachment after Descemet Membrane Endothelial Keratoplasty

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

We congratulate Balachandran and associates on their excellent article regarding spontaneous corneal clearance despite graft detachment after Descemet membrane endothelial keratoplasty. They raise interesting questions and the possibility that Fuchs dystrophy may be treatable by either just stripping off the central Descemet membrane (DM) alone or by combining that with the mere insertion of a scrolled-up donor graft of DM and endothelium into the anterior chamber without subsequent positioning. They report low but gradually increasing cell counts in the recipient between 3 and 6 to 9 months. It has now been a year and a half since those surgeries. Have the central cell counts continued to improve with improving morphologic features, or have they stabilized? Would the authors consider join...

Reply

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

We thank Sakarya and associates regarding their question about screening of amniotic membrane donors. Indeed, it is a very important issue that should not be neglected, both ethically and from a medicolegal standpoint. (Source: American Journal of Ophthalmology)

Prospective Comparison of Two Suturing Techniques of Amniotic Membrane Transplantation for Symptomatic Bullous Keratopathy

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

We read with great interest the article entitled “Prospective comparison of two suturing techniques of amniotic membrane transplantation for symptomatic bullous keratopathy” by Altiparmak and associates. The authors concluded that modified amniotic membrane transplantation (AMT) suturing technique has a similar epithelialization rate to standard AMT suturing to the cornea. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

We thank the correspondent for her comment on our recent publication reporting that total posterior vitreous detachment (PVD) by ultrasound was associated with 3 times as many cases of dry age-related macular degeneration (AMD) as cases with wet AMD (69% vs 21%; P = .002). An attached posterior vitreous cortex by optical coherence tomography (OCT) was associated with 4 times as many cases of wet AMD as dry AMD (38% vs 10%; P = .008). We agree with the proposal that one of the plausible mechanisms by which PVD may be salubrious and vitreomacular adhesion may be deleterious is that oxygenation of the macula is enhanced in the absence of an attached posterior vitreous. Indeed, in our original publication, the third sentence of the fifth paragraph of the discussion states that: “The presence...

Vitreomacular Adhesion in Active and End-Stage Age-Related Macular Degeneration

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

The article by Robison and associates, titled “Vitreomacular Adhesion in Active and End-Stage Age-Related Macular Degeneration,” is an important one. It confirms prior findings in a larger study published by some of the authors in 2007. Both articles together strongly suggest a role of the vitreous gel in the pathogenesis of active exudative age-related macular degeneration (AMD) when the cortical vitreous is still attached to the macula. However, I find the potential mechanisms proposed by the authors to explain this striking finding to be unsatisfactory. In light of new information on a recently discovered biochemical property of the vitreous gel, I would like to propose another mechanism. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

We read the letter from Dr Maloney with great interest and wholeheartedly agree that the off-label use of drugs and devices is appropriate in routine clinical practice. If he assumed that we held a different position, then he is mistaken and perhaps we were unclear. In ophthalmology, off-label drugs and devices play an enormously important role in our ability to care for patients. We agree that clinical trials can sometimes point clinicians in the wrong direction, and that physicians have an ethical obligation to provide correct and appropriate care to their patients. This means they should be competent to assess the validity of clinical research and should not reflexively or thoughtlessly follow treatment protocols. The standards of evidence-based practice demand nothing less. (Source: Am...

Off-Label Use of Drugs and Devices

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:57 +0100

In their editorial “When is off-label drug use in the Patient's Best Interest?,” Rosenfeld and Goodman raise ethical questions about the off-label use of intravitreal Infliximab to treat neovascular age-related macular degeneration by Theodossiadis and associates. Rosenfeld and Goodman confuse unproven with off-label. They say that “patients had not failed ranibizumab therapy when the decision was made to change them from an approved drug to an unproven off-label drug” (italics added). Later they ask whether “Theodossiadis and associates violate[d] international standards by performing off-label Infliximab injections?” (italics added) and stated that off-label treatments must be preceded by a “robust consent process.” (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:55 +0100

Spectral-Domain Optical Coherence Tomography: A Comparison of Modern High-Resolution Retinal Imaging Systems

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:54 +0100

Conclusions: Advances in high-resolution imaging of the anterior and posterior segment have revealed new in vivo details of anatomic, physiologic, and pathologic data for the practice of ophthalmology. Compared with time-domain OCT, SD OCT tends to derive increased retinal thickness and decreased nerve fiber layer thickness measurements. This is likely because of increased depth of resolution and greater volume of data acquired with each scan. Interdevice comparison is not practical because of differences in individual segment boundary algorithms. Improvements in photoreceptor inner segment–outer segment layer visualization should aid our understanding of visual dysfunction in a variety of retinal pathologic features. As the technology develops, SD OCT will continue to provide new insigh...

From the Laboratory to the Clinic: Molecular Genetic Testing in Pediatric Ophthalmology

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:54 +0100

Conclusions: Entry into the genetic testing system often is via the patient's ophthalmologist. Collaboration with geneticists and genetic counselors, use of web sites to keep up with the ever-changing availability and detection rates, and knowledge of clinical trials, when combined with excellent clinical diagnosis, can improve diagnosis and allow eligible patients to participate in treatment trials. (Source: American Journal of Ophthalmology)

Propensity Score Methods

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:53 +0100

The design of nonrandomized studies for causal effect estimation is an important enterprise. Although propensity score methods are now standard statistical tools in many branches of medical research and epidemiology for attacking this goal, with rare exception, they have not been used in ophthalmic research. Because propensity score methods also have been misused in some applications in medicine, this editorial briefly outlines their correct use. (Source: American Journal of Ophthalmology)

When Should Anti-Vascular Endothelial Growth Factor Treatment Be Stopped in Age-Related Macular Degeneration?

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:53 +0100

Anti–vascular endothelial growth factor (VEGF) therapy has rapidly become the current standard treatment for exudative age-related macular degeneration (AMD). Although the anti-VEGF drugs currently applied to the eye have only angiostatic effects, the positive results of the ranibizumab clinical trials and the current use of bevacizumab surpassed ophthalmologists' expectations for the treatment of exudative AMD. For instance, in the MARINA trial, which included patients with subfoveal occult choroidal neovascularization (CNV), the mean improvement in visual acuity (VA) was 6.7 letters on the ETDRS chart in eyes treated by monthly ranibizumab injections. In the ANCHOR trial, which included patients with classic subfoveal CNV, this improvement even reached 11.2 letters in treated eyes. In ...

Are You Compliant With Addressing Glaucoma Adherence?

American Journal of Ophthalmology — Sat, 19 Dec 2009 14:47:53 +0100

C. Everett Koop, the former U.S. Surgeon General, famously remarked, “Drugs don't work in patients who don't take them.” Researchers define “compliance” as the extent to which patients take medications as prescribed by their health care provider. Some researchers prefer the term “adherence,” since it suggests a treatment alliance between the patient and provider. However, both terms are imperfect descriptions of medication-taking behavior. For this Editorial, I use adherence as the descriptive term for taking medications as prescribed. (Source: American Journal of Ophthalmology)

Management of Acute Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Utilizing Amniotic Membrane and Topical Corticosteroids

American Journal of Ophthalmology — Fri, 11 Dec 2009 00:00:00 +0100

Conclusions: Amniotic membrane coverage of the ocular surface in its entirety coupled with the use of intensive short-term topical corticosteroids during the acute phase of SJS and TEN is associated with the preservation of good visual acuity and an intact ocular surface. Partial amniotic membrane coverage of the ocular surface may not serve to minimize the cicatrizing ocular sequelae of SJS and TEN as effectively as complete coverage. (Source: American Journal of Ophthalmology)

Restoration of Photoreceptor Outer Segment after Vitrectomy for Retinal Detachment

American Journal of Ophthalmology — Wed, 25 Nov 2009 00:00:00 +0100

Conclusions: The IS/OS line at the fovea recovered gradually after surgery. The postoperative visual acuity was correlated with a restored IS/OS line. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:08 +0100

(Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:08 +0100

Media Type: Textbook with DVD-ROM Synopsis: This textbook provides detailed authoritative guidance on many of the commonly performed vitreoretinal surgical procedures as well as a number of more complex procedures including surgery for retinopathy of prematurity and intraocular tumors. Written by experts in the field, well-illustrated, complemented with a DVD-ROM, it provides a level of detail that vitreoretinal fellows and ophthalmology trainees with a keen interest in vitreoretinal surgery will find extremely useful. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:08 +0100

Media Type: Textbook Synopsis: LASIK has been the patron of refractive surgery to allow people to eliminate their dependency on corrective lenses. Techniques to perform this procedure have been enhanced in order to produce safer results. One technique implements femtosecond lasers to create a corneal flap necessary for LASIK. Femtodynamics, A Guide to Laser Settings and Procedure Techniques to Optimize Outcomes with Femtosecond Lasers is a reference text that provides a very thorough explanation of utilizing this technique. This book is aimed towards any refractive surgeon interested in incorporating bladeless LASIK into their practice. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:08 +0100

Media Type: Textbook Synopsis: Drs. Purvin and Kawasaki have written a case-based book about the twists and turns in common and not-so-common neuro-ophthalmology diseases. As the authors note in the preface, “this book is meant to bridge the gap between textbook and everyday experience of the clinician.” This unique book successfully fulfills that promise – and does so in an entertaining way. A fun neuro-ophthalmology book! (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:06 +0100

We appreciate the interest of Dr Pai and associates in our article, and we thank them for their thoughtful comments. We fully agree that less stringent standards for low vision may be appropriate for children. Recent studies have suggested that decrements in self-reported visual function may be observed among children at vision levels of 6/12, and correction of vision deficits even in the range of 6/9 may be associated with significant improvements in children's visual functioning. This is in contrast to the cut-off of 6/18 as promulgated more widely by the World Health Organization (WHO), and which was used in our study. (Source: American Journal of Ophthalmology)

Low Vision Among Preschool Children in the Beijing Study of Visual Impairment

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:06 +0100

Lu and associates recently presented findings from a large-sample epidemiologic study that screened the visual acuity (VA) of 30 137 preschool children residing in Beijing, of whom 17 699, aged between 3 and 6 years of age, were used for their report. The authors have correctly referenced that low vision is more frequent and problematic than blindness among children worldwide. Of the 17 699 participants, 76 (0.43%) had a bilateral presenting VA less than 6/18, of whom 57 (0.32%) were correctable with pinhole and 14 (0.08%) were not correctable, and 5 (0.03%) of these children were bilaterally blind with best-corrected VA less than 3/60 (20/400), using the World Health Organization (WHO) definitions for these conditions. The definition of low vision, a presenting VA less than 6/18 (20/60), ...

Reply

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:06 +0100

We are grateful to Dr Nowroozzadeh for his interest and comments regarding our article “Accommodative Loss After Retinal Cryotherapy.” In our article, we cited two mechanisms for the transient accommodative loss after Cryo based on the different reports that we have encountered. We believed, however, that transient thermal damage to the short posterior ciliary nerves (SPCNs) was the most probable cause. We agree of course that ciliochoroidal effusion is also a possible mechanism. As Dr Nowroozzadeh noted, mydriasis and myopia can occur after retinal ablation. But unfortunately, the purpose of our study was only to investigate the accommodative loss. A more detailed study needs to be done in the future to include refractive examination and pupillary size measurement to pinpoint the real...

Accommodative Loss After Retinal Ablation

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:05 +0100

I read with great interest the article by Uno and associates, which was published in the January 2009 issue of The Journal. In that article, it stated that the accommodative amplitude transiently decreased after retinal cryotherapy. The authors suggested two possible mechanisms in this regard. Firstly, they cited several reports that have been published on transient accommodative and pupillary disturbances after cryotherapy or laser photocoagulation. Given that both the iris sphincter muscles and ciliary muscles are innervated by short posterior ciliary nerves (SPCN), they concluded that the observed transient accommodative loss and mydriasis may be because of ciliary body and iris palsy resulting from direct thermal damage to the SPCNs. They also suggested another mechanism, which origina...

Reply

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:05 +0100

Samarawickrama and associates have recently found in a population-based study of 6- and 12-year-old children that there was no significant difference in average peripapillary retinal nerve fiber layer (RNFL) thickness measured with optical coherence tomography (OCT) between amblyopic and fellow eyes of children with unilateral amblyopia. The mean peripapillary RNFL thickness of the amblyopic eyes was 1.9 μm thicker. Our previously reported data were very similar. We studied 37 subjects 7 to 12 years of age with amblyopia from anisometropia, strabismus, or both combined. Overall we reported that amblyopic eyes were on average 1.8 μm thicker (95% confidence interval, −0.6 to 4.3). (Source: American Journal of Ophthalmology)

Thickness of the Retinal Nerve Fiber Layer in Amblyopia

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:05 +0100

The recent article by Repka and associates is an interesting and welcome addition to the growing literature investigating whether amblyopia is associated with any structural changes in the retina. The authors report on a sample of 37 patients with a mean age of 9.2 years, and found no differences in retinal nerve fiber layer (RNFL) parameters between amblyopic eyes and normal fellow eyes. From this, they suggest that an optic neuropathy is not an important element of moderate anisometropic or strabismic amblyopia. However, the authors did not state whether any of their sample had previously received treatment for amblyopia, and whether this was associated with any differences in parameters. Could the authors please provide these data? (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:03 +0100

Missing Data: What a Little Can Do, and What Researchers Can Do in Response

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:03 +0100

If only 5% of the data values are missing, is it OK to drop the cases with incomplete data and analyze only the cases with complete data? Questions along these lines frequently are directed to statisticians by applied researchers. In considering the potential impact of missing data, an example illustrates why such an apparently simple question does not have a simple answer. (Source: American Journal of Ophthalmology)

Rationale for Radiotherapy in Thyroid Eye Disease

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:03 +0100

Low-dose orbital radiotherapy (20 Gy) remains a common medical therapy for treatment of thyroid eye disease (TED). Since the early 1970s, when clinical series using the common current dose suggested a clinical benefit in at least some patients, orbital radiotherapy has been used in an attempt to reduce inflammation and alter the course of the disease. Over the past 4 decades, a wealth of data has produced conflicting results regarding its effect. (Source: American Journal of Ophthalmology)

The Clinical Site-Reading Center Partnership in Clinical Trials

American Journal of Ophthalmology — Tue, 24 Nov 2009 15:39:02 +0100

Former U.S. President Martin Van Buren once wrote, “It is easier to do a job right than to explain why you didn't.” This dictum is applicable to all aspects of clinical trials. The clinical site-reading center partnership focuses on collection of high-quality, standardized, unbiased imaging data. High-quality data collection by clinical sites according to standardized methodology has been central to the majority of studies leading to the most exciting advancements in ophthalmic patient care. The current model of multicenter clinical trials employing coordinating centers and reading centers has evolved partly to promote a high-level of data quality through training, certification, and monitoring of clinical site data collection. This Editorial will briefly review the roles of reading ce...

Surgical Procedure for Correcting Globe Dislocation in Highly Myopic Strabismus

American Journal of Ophthalmology — Tue, 24 Nov 2009 00:00:00 +0100

Conclusions: This surgical procedure to restore the dislocated globe back into the muscle cone by uniting muscle bellies of the superior rectus and lateral rectus muscles is effective for highly myopic strabismus. (Source: American Journal of Ophthalmology)

Subretinal Hemorrhages Associated with Age-Related Macular Degeneration in Patients Receiving Anticoagulation or Antiplatelet Therapy

American Journal of Ophthalmology — Tue, 24 Nov 2009 00:00:00 +0100

Conclusions: Our results indicate that anticoagulants and antiplatelet agents are strongly associated with the development of large subretinal hemorrhages in AMD patients. Moreover, arterial hypertension is a strong risk factor for large subretinal hemorrhages in AMD patients receiving anticoagulants or antiplatelet agents. Physicians should be aware of an increased risk of extensive subretinal hemorrhage in AMD patients when deciding on the initiation and duration of anticoagulant and antiplatelet therapy. (Source: American Journal of Ophthalmology)

Cost-Effectiveness of the Boston Keratoprosthesis

American Journal of Ophthalmology — Tue, 24 Nov 2009 00:00:00 +0100

Conclusions: Comparable to corneal transplantation, with a cost-effectiveness between $12 000 and $16 000 per QALY, the keratoprosthesis can be considered highly cost-effective. (Source: American Journal of Ophthalmology)

Staphylococcus aureus Endophthalmitis: Antibiotic Susceptibilities, Methicillin Resistance, and Clinical Outcomes

American Journal of Ophthalmology — Wed, 18 Nov 2009 00:00:00 +0100

Conclusions: Although all MSSA and MRSA isolates were sensitive to vancomycin, fewer than half of MRSA isolates were sensitive to the fourth-generation fluoroquinolones. Visual acuity outcomes between MRSA and MSSA eyes were not significantly different. (Source: American Journal of Ophthalmology)

Ten-Year Longitudinal Visual Function and Nd: YAG Laser Capsulotomy Rates in Patients Less Than 65 Years at Cataract Surgery

American Journal of Ophthalmology — Wed, 18 Nov 2009 00:00:00 +0100

Conclusion: Ten years after surgery, subjective and objective visual function remained stable in most patients younger than 65 years at surgery. More than one-third had received a posterior capsulotomy. Only a few patients with posterior capsular opacification requiring Nd:YAG were untreated at the 10-year follow-up. (Source: American Journal of Ophthalmology)

Late Varicella-Zoster Virus Dendriform Keratitis in Patients With Histories of Herpes Zoster Ophthalmicus

American Journal of Ophthalmology — Wed, 11 Nov 2009 00:00:00 +0100

Conclusions: Late dendriform lesions associated with HZO are foci of productive VZV infection. Lesions can be treated effectively with topical or systemic antiviral agents. Patients can have multiple recurrences of dendriform lesions despite treatment. (Source: American Journal of Ophthalmology)

Standard-Fluence versus Low-Fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy: A Nonrandomized Clinical Trial

American Journal of Ophthalmology — Fri, 06 Nov 2009 00:00:00 +0100

Conclusions: In most of the eyes, both standard-fluence PDT and low-fluence PDT resulted in complete subretinal fluid reabsorption with visual acuity improvement. Choroidal hypoperfusion related to PDT could be reduced by low-fluence PDT. (Source: American Journal of Ophthalmology)

Ability of New Vital Dyes to Stain Intraocular Membranes and Tissues in Ocular Surgery

American Journal of Ophthalmology — Fri, 06 Nov 2009 00:00:00 +0100

Conclusions: Brilliant blue shows the best ILM staining, whereas bromophenol blue, evans blue, and light green also stain ILM. Most dyes bind well to LC, vitreous, and ERM. (Source: American Journal of Ophthalmology)

Rotational Stability of a Single-Piece Hydrophobic Acrylic Intraocular Lens During Removal of Ophthalmic Viscosurgical Devices

American Journal of Ophthalmology — Fri, 06 Nov 2009 00:00:00 +0100

Conclusions: This study showed that a significant amount of IOL rotation occurred during OVD removal. Intraoperative rotational stability of IOL was greater with Viscoat than with Healon GV. (Source: American Journal of Ophthalmology)

Ultrasound Biomicroscopic Analysis of Iris-Sutured Foldable Posterior Chamber Intraocular Lenses

American Journal of Ophthalmology — Fri, 06 Nov 2009 00:00:00 +0100

Conclusions: Iris-sutured PCIOL haptics were found to be in the ciliary sulcus or over the ciliary body with no significant tilt on UBM analysis. The procedure respects the angle anatomy, and no evidence of angle closure was found. The anterior chamber was deeper than has been reported previously for scleral sutured PCIOLs and was similar to that of pseudophakic eyes. This may have implications for surgical technique, IOL power calculations, and postoperative complications. (Source: American Journal of Ophthalmology)

Predictive Factor Analysis for Successful Performance of Iris Recognition-Assisted Dynamic Rotational Eye Tracking during Laser In Situ Keratomileusis

American Journal of Ophthalmology — Fri, 06 Nov 2009 00:00:00 +0100

Conclusions: Intraoperative cyclotorsional activity depends on the age, gender, and duration of ablation (pulses delivered). Femtosecond flaps do not seem to have a disadvantage over microkeratome flaps as far as iris recognition and success of intraoperative dynamic rotational tracking is concerned. (Source: American Journal of Ophthalmology)

The Lacrimal Bypass Tube for Lacrimal Pump Failure Attributable to Facial Palsy

American Journal of Ophthalmology — Fri, 06 Nov 2009 00:00:00 +0100

Conclusions: In this highly selected group of patients, Jones tube insertion led to symptom improvement in 83.3% postoperatively and in 72.2% at median follow-up of 27.5 months. Tube extrusion and migration were common, although such complications were not unexpected and were treatable. (Source: American Journal of Ophthalmology)

Management of Iris Melanomas With 125Iodine Plaque Radiotherapy

American Journal of Ophthalmology — Wed, 04 Nov 2009 00:00:00 +0100

Conclusions: Plaque radiotherapy is a safe and effective conservative treatment option for IM, although cataract is a common, yet treatable, complication. This treatment scheme circumvents an intraocular procedure and may avoid the dissemination of malignant cells, and provides a margin of safety in the treatment of clinically undetectable disease. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:39 +0100

(Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:39 +0100

We are writing to address the concerns raised by our colleagues, Pirouzian and associates, regarding our recently published manuscript. We want to thank Pirouzian and associates for bringing the following points to our attention. (Source: American Journal of Ophthalmology)

Refractive Surgery in Children

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:39 +0100

We read with interest the published Perspective article on “Refractive Surgery in Children” by Daoud and associates. We applaud the authors in undertaking a comprehensive investigative PubMed literature search-review on refractive surgery in children. (Source: American Journal of Ophthalmology)

Translation of Clinical Studies to Clinical Practice: Survey on the Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:39 +0100

Translational 2 or T2, research refers to the conversion of findings from clinical studies into actual practice. For example, a recent international survey on the management of optic neuritis showed that although clinical trials have changed the management of acute optic neuritis around the world, many neurologists and ophthalmologists still do not evaluate and treat acute isolated optic neuritis patients according to the best evidence. (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:38 +0100

Reticular Macular Disease

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:37 +0100

Conclusions: RMD is a single disease entity with stereotypical presentations in multiple imaging methods, of which RPD is one. Autofluorescence, infrared imaging, and indocyanine green angiography suggest that it involves the retinal pigment epithelium and choriocapillaris, whereas photographic patterns implicate the inner choroid. Infrared imaging, unlike other methods, can demonstrate RMD in the central macula. RMD is associated with progression to advanced age-related macular degeneration, perhaps on an inflammatory basis. RMD deserves wider recognition among clinicians caring for elderly patients. (Source: American Journal of Ophthalmology)

Angle-Closure Glaucoma–Simpler Answers to Complex Mechanisms: LXVI Edward Jackson Memorial Lecture

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:36 +0100

Conclusions: Angle-closure and angle-closure glaucoma result from disturbed physiological mechanisms more than from simple anatomic measures, and future predictive testing can exploit knowledge of these factors. (Source: American Journal of Ophthalmology)

Risk Interpretation, Perception, and Communication

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:36 +0100

In a recent Statistics Editorial, I discussed the definition of a disease risk and various ways of comparing risks across groups. Beyond the necessary statistical tools to estimate and compare risk, as health professionals we need to understand how physicians, counselors, and the general public understand and interpret risk information. The success of scientific studies on risk factors and appropriate interventions depends on a researcher's skills in appropriately interpreting risk from data sources, communicating that risk effectively, and on consumers perceiving the information correctly. In passing, note that researchers may use subtle alternatives to risk—for example, expected years of life lost, or quality of life measures—to quantify comparison of different exposure groups, conce...

The Perils of Glaucoma Surgical Outcome Analysis

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:36 +0100

The “gold standard” for glaucoma incisional surgery has been trabeculectomy, a guarded filtration procedure that was introduced 40 years ago by Watson and Cairns. The operation has been modified over the years to improve success by utilizing antimetabolites and lowering complications by staged release of scleral flap sutures with releasable sutures or laser suture lysis. Also ushered in almost 30 years ago was the tube shunt for refractory glaucomas by Molteno. Modifications since the introduction of tube shunts have been the incorporation of a valve, using an internal and/or external tube ligature, and changing the reservoir dimensions, style, and material. (Source: American Journal of Ophthalmology)

Sympathetic Ophthalmia: What Have We Learned?

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:35 +0100

Sympathetic ophthalmia (SO) is a rare bilateral granulomatous uveitis that occurs after ocular trauma or surgery to 1 eye. The eye sustaining the injury is referred to as the inciting eye and the fellow eye is called the sympathizing eye. The cause of SO has not been understood completely, but the underlying pathophysiologic feature is believed to be an autoimmune reaction against the exposed ocular antigens from the inciting eye. The time to development of SO varies from 2 weeks to 50 years, with the disease developing in approximately 90% of patients within 1 year of injury. Since MacKenzie and Fuchs' clinical description of the disease approximately one century ago, enucleation of the inciting eye in an attempt to influence the course of the disease in the sympathizing eye has been a co...

Deep Anterior Lamellar Keratoplasty: When Should it Replace Penetrating Keratoplasty?

American Journal of Ophthalmology — Thu, 29 Oct 2009 14:51:35 +0100

For nearly a half century, penetrating keratoplasty (PKP) has been the surgical treatment of choice for visual rehabilitation of corneal blindness. Recently, endothelial keratoplasty (EK) techniques, which offer the advantages of preservation of relatively normal corneal stroma and architecture and rapid visual rehabilitation, have replaced PKP as the surgical treatment of choice in most cases of endothelial dysfunction. Conversely, deep anterior lamellar keratoplasty (DALK), which offers the advantages of preservation of the recipient endothelium and elimination of immune-mediated endothelial rejection, has been introduced as a possible alternative to PKP in eyes with keratoconus and stromal opacities attributable to dystrophies, degenerations, trauma, and microbial keratitis. (Source: Am...

Height, Stunting, and Refractive Error Among Rural Chinese Schoolchildren: The See Well to Learn Well Project

American Journal of Ophthalmology — Thu, 29 Oct 2009 00:00:00 +0100

Conclusion: Results from this cross-sectional study are not consistent with the hypothesis that nutritional status is a determinant of RE in this setting. (Source: American Journal of Ophthalmology)

Late Increased Risk of Retinal Detachment After Cataract Extraction

American Journal of Ophthalmology — Thu, 29 Oct 2009 00:00:00 +0100

Conclusions: Our study showed that patients with high myopia may be at increased risk for late pseudophakic RD after 4 years, especially in males. (Source: American Journal of Ophthalmology)

Clinical Benefits of the Boston Ocular Surface Prosthesis

American Journal of Ophthalmology — Thu, 29 Oct 2009 00:00:00 +0100

Conclusions: The Boston Ocular Surface Prosthesis significantly improved VA and visual functioning in patients with corneal ectasia, irregular astigmatism, and ocular surface disease who had failed conventional therapies. (Source: American Journal of Ophthalmology)

Airsoft Gun–Related Ocular Injuries: Novel Findings, Ballistics Investigation, and Histopathologic Study

American Journal of Ophthalmology — Thu, 29 Oct 2009 00:00:00 +0100

Conclusions: Airsoft gun injuries affect mainly young men and can be visually threatening. Typical ocular injuries along with a unique form of corneal erosion can be seen. (Source: American Journal of Ophthalmology)

Pegaptanib Sodium for Macular Edema Secondary to Branch Retinal Vein Occlusion

American Journal of Ophthalmology — Wed, 28 Oct 2009 00:00:00 +0100

Conclusions: Intravitreous pegaptanib offers a promising alternative as a treatment for macular edema secondary to BRVO. (Source: American Journal of Ophthalmology)

Subthreshold Micropulse Diode Laser Photocoagulation for Diabetic Macular Edema in Japanese Patients

American Journal of Ophthalmology — Wed, 28 Oct 2009 00:00:00 +0100

Purpose: To assess the efficacy and safety of subthreshold micropulse diode laser photocoagulation for diabetic macular edema (ME).Design: Prospective, nonrandomized interventional case series.Methods: setting: Institutional. patients: Thirty-six consecutive diabetic patients (43 eyes) with clinically significant ME and a central macular thickness (CMT) (Source: American Journal of Ophthalmology)

Incidence and Factors Related to Macular Hole Reopening

American Journal of Ophthalmology — Wed, 28 Oct 2009 00:00:00 +0100

Conclusions: ILM peeling significantly decreases the incidence of the reopening of an MH. Although the pathogenesis of the reopening of MHs is still undetermined, myopia and intraoperative retinal tears may be related to the reopening. (Source: American Journal of Ophthalmology)

Intratarsal Keratinous Cysts of the Meibomian Gland: Distinctive Clinicopathologic and Immunohistochemical Features in 6 Cases

American Journal of Ophthalmology — Wed, 28 Oct 2009 00:00:00 +0100

Conclusions: After chalazia and sebaceous cell tumors, Meibomian gland keratinous cysts seem to be the third most common primary intratarsal lesion. Anterior fixation to the tarsus and posterior protrusion beneath the palpebral conjunctiva without inflammation suggest the diagnosis. Histopathologic and immunohistochemical evaluations can distinguish unequivocally the current entity from common epidermal cysts. The optimal treatment consists of an en bloc excision of the cyst with a tarsectomy, or else wide excision with intratarsal cautery of any remnants of the cellular lining. (Source: American Journal of Ophthalmology)

Evaluation of Sub-Tenon Triamcinolone Acetonide Injections in the Treatment of Scleritis

American Journal of Ophthalmology — Wed, 28 Oct 2009 00:00:00 +0100

Conclusions: Sub-Tenon TA injections may be a useful adjunct to achieving transient, partial improvement of subjective pain and objective inflammation in patients with scleritis while awaiting systemic medications to take effect. Adverse events were manageable in this small series. (Source: American Journal of Ophthalmology)

Treatment With Voriconazole in 3 Eyes With Resistant Acanthamoeba Keratitis

American Journal of Ophthalmology — Wed, 28 Oct 2009 00:00:00 +0100

Conclusions: We report the use of topical and intrastromal voriconazole in successfully treating AK in cases of chlorhexidine- and hexamidine-resistant Acanthamoeba. Voriconazole may be a promising adjuvant agent in treating AK. (Source: American Journal of Ophthalmology)

Ocular Surface Reconstruction With Autologous Nasal Mucosa in Cicatricial Ocular Surface Disease

American Journal of Ophthalmology — Wed, 28 Oct 2009 00:00:00 +0100

Conclusions: Nasal mucosa, which has the advantage of well-developed parallel vasculature, enriched goblet cells, and plenty of stem cells, may be an ideal substitute for a cicatricial ocular surface. Transplantation of autologous nasal mucosa is a very effective method for achieving ocular surface reconstruction in cicatricial ocular surface diseases. (Source: American Journal of Ophthalmology)

The Vitreous Gel: More than Meets the Eye

American Journal of Ophthalmology — Wed, 28 Oct 2009 00:00:00 +0100

Conclusions: An intact gel vitreous is central to a healthy human eye. We now understand that age-related liquefaction of the vitreous gel accompanies several age-related ocular diseases. The field of ophthalmology would benefit from future research to understand age-related vitreous liquefaction and to identify its cause. (Source: American Journal of Ophthalmology)

Two-Year Visual Results for Older Asian Women Treated With Photodynamic Therapy or Bevacizumab for Myopic Choroidal Neovascularization

American Journal of Ophthalmology — Tue, 20 Oct 2009 00:00:00 +0100

Conclusions: These findings indicate that the effects of PDT and IVB have a different time course, and that IVB provides a significantly better BCVA than PDT for mCNV over the long-term. (Source: American Journal of Ophthalmology)

Long-term Outcome of Idiopathic Macular Hole Surgery

American Journal of Ophthalmology — Tue, 20 Oct 2009 00:00:00 +0100

Conclusions: Cataract extraction, CME, or preoperative MH diameter measured by optical coherence tomography were not identified as risk factors for IMH reopening. (Source: American Journal of Ophthalmology)

Ocular Surface Squamous Neoplasia After Corneal Graft

American Journal of Ophthalmology — Tue, 20 Oct 2009 00:00:00 +0100

Conclusion: Corneal OSSN should be considered in patients using chronic topical steroids for corneal graft. Nonsurgical management with topical chemotherapy or photodynamic therapy can achieve tumor control. (Source: American Journal of Ophthalmology)

Sequential Glaucoma Implants in Refractory Glaucoma

American Journal of Ophthalmology — Mon, 19 Oct 2009 00:00:00 +0100

Conclusions: A second glaucoma implant may effectively lower IOP in eyes with refractory glaucoma. (Source: American Journal of Ophthalmology)

Scleritis and Systemic Disease Association in a Community-Based Referral Practice

American Journal of Ophthalmology — Mon, 19 Oct 2009 00:00:00 +0100

Conclusions: The association between scleritis and systemic disease in a community-based referral practice may be lower than in tertiary referral or university-based centers. Although thorough systemic disease evaluation is warranted in scleritis patients, most patients with associated systemic disease will have such a diagnosis prior to the development of scleritis. The need to institute aggressive systemic therapy cannot be predicted by the presence of an associated systemic disease. Infliximab and mycophenolate mofetil are useful additions to the scleritis practitioner's armamentarium for steroid-refractory scleritis. (Source: American Journal of Ophthalmology)

Aqueous Vascular Endothelial Growth Factor as a Predictor of Macular Thickening Following Cataract Surgery in Patients With Diabetes Mellitus

American Journal of Ophthalmology — Mon, 19 Oct 2009 00:00:00 +0100

Conclusions: Aqueous VEGF was significantly positively associated with a clinically meaningful change in CSF in diabetic patients 1 month following cataract surgery. Accounting for preoperative CSF was important. Further study is indicated. (Source: American Journal of Ophthalmology)

Intravitreous Vascular Endothelial Growth Factor and Hypoxia-Inducible Factor 1a in Patients With Proliferative Diabetic Retinopathy

American Journal of Ophthalmology — Mon, 19 Oct 2009 00:00:00 +0100

Conclusions: Intravitreous VEGF and HIF-1a in diabetic patients with PDR are increased and related mutually. VEGF and HIF-1a, especially VEGF, are associated with the angiogenesis of PDR. (Source: American Journal of Ophthalmology)

Vision-Related Function After Scleral Lens Fitting in Ocular Complications of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

American Journal of Ophthalmology — Mon, 19 Oct 2009 00:00:00 +0100

Conclusions: Scleral lens use appears to be efficient and safe for visual rehabilitation of refractory ocular surface disease attributable to TEN and SJS. (Source: American Journal of Ophthalmology)

Pulsar Perimetry in the Diagnosis of Early Glaucoma

American Journal of Ophthalmology — Mon, 05 Oct 2009 00:00:00 +0100

Conclusions: Pulsar T30W test is a rapid and easy perimetric method, showing higher sensitivity than SAP in detecting early glaucomatous VF loss. Its diagnostic ability is good for detecting early perimetric POAG eyes and fair for GON eyes. Pulsar performance was comparable with FDT, HRT, and GDx, even if the agreement between instruments was poor to fair. (Source: American Journal of Ophthalmology)

Peripheral Exudative Hemorrhagic Chorioretinopathy: A Clinical, Angiographic, and Histologic Study

American Journal of Ophthalmology — Mon, 05 Oct 2009 00:00:00 +0100

Conclusions: Peripheral exudative hemorrhagic chorioretinopathy is a characteristic peripheral degenerative disorder, frequently with benign outcome, although it can be vision threatening because of hemorrhage or exudation. Clinical features are helpful for its diagnosis. FA and ICGA contribute valuable evidence to the hypothesis of a neovascular origin, but further histologic studies are needed to prove this hypothesis. (Source: American Journal of Ophthalmology)

Incorporating Mortality Risk into Estimates of 5-Year Glaucoma Risk

American Journal of Ophthalmology — Mon, 05 Oct 2009 00:00:00 +0100

Conclusions: Shortened life expectancy reduces 5-year risk of developing glaucoma. Thus, mortality risk is another factor clinicians should consider when deciding whether to initiate treatment of glaucoma suspects. (Source: American Journal of Ophthalmology)

Comparison of Prevalence of Dengue Maculopathy During Two Epidemics With Differing Predominant Serotypes

American Journal of Ophthalmology — Mon, 05 Oct 2009 00:00:00 +0100

Conclusions: The prevalence of dengue maculopathy, age of clinical disease, and extent of liver damage differs between epidemics with different predominant serotypes. (Source: American Journal of Ophthalmology)

Bevacizumab vs Ranibizumab for Age-Related Macular Degeneration: Early Results of a Prospective Double-Masked, Randomized Clinical Trial

American Journal of Ophthalmology — Mon, 05 Oct 2009 00:00:00 +0100

Conclusion: Early results of a head-to-head, randomized, double-masked, prospective, single-center controlled trial between bevacizumab and ranibizumab show no difference in efficacy between the two treatments for choroidal neovascularizaton in the treatment of age-related macular degeneration. As this study conveys results of a small number of patients, further studies with larger sample sizes are needed in order to establish statistical significance. (Source: American Journal of Ophthalmology)

Visually Significant and Nonsignificant Complications Arising From Descemet Stripping Automated Endothelial Keratoplasty

American Journal of Ophthalmology — Mon, 05 Oct 2009 00:00:00 +0100

Conclusions: While DSAEK is a viable alternative to penetrating keratoplasty, serious complications may still occur postoperatively. While certain rare complications like endophthalmitis, epithelial ingrowth, and suture abscess may affect vision, more common complications such as decentered lenticles and partial peripheral detachments are less likely to affect visual outcome. (Source: American Journal of Ophthalmology)

Molecular Prognostic Testing and Individualized Patient Care in Uveal Melanoma

American Journal of Ophthalmology — Mon, 05 Oct 2009 00:00:00 +0100

Conclusions: Many cytogenetic and molecular prognostic tests for uveal melanoma have been reported, yet few have reached the standards required for routine clinical testing. Clinicians must understand the statistical and scientific limitations of the tests they are using, and appropriate ethical oversight is essential until such time that validated testing instruments are available that are performed in a standardized clinical testing environment. Well-controlled prospective studies are necessary to identify the most accurate, widely accessible, and affordable tests for routine clinical use. (Source: American Journal of Ophthalmology)

The Association of Smoking and Alcohol Use With Age-related Macular Degeneration in the Oldest Old: The Study of Osteoporotic Fractures

American Journal of Ophthalmology — Thu, 01 Oct 2009 00:00:00 +0100

Conclusions: The magnitude of the greater-than-additive effect of smoking on the age-adjusted risk of AMD reinforces recommendations to quit smoking even for older individuals. (Source: American Journal of Ophthalmology)

The Associations Between Blood Levels of Homocysteine, Folate, Vitamin B12, and Retinal Vascular Caliber

American Journal of Ophthalmology — Thu, 01 Oct 2009 00:00:00 +0100

Conclusions: Retinal vascular caliber is associated with tHcy in men but not women. This finding may reflect the stronger association between blood pressure and tHcy in men than in women. (Source: American Journal of Ophthalmology)

Comprehensive Analysis of Complement Factor H and LOC387715/ARMS2/HTRA1 Variants With Respect to Phenotype in Advanced Age-Related Macular Degeneration

American Journal of Ophthalmology — Thu, 01 Oct 2009 00:00:00 +0100

Conclusions: Several polymorphisms examined in the LOC387715/ARMS2/HTRA1 locus, but none in the CFH region, correlated with specific phenotypic attributes of AMD. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology via MedWorm.com

Contents

Scientific Referees 2009

Reporting Visual Acuities

Spontaneous Corneal Clearance Despite Graft Detachment in Descemet Membrane Endothelial Keratoplasty

Reply

Angle-Closure Glaucoma—Simpler Answers to Complex Mechanisms

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Stratus OCT Signal Strength and Reliability of Retinal Nerve Fiber Layer Measurements

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Increased Likelihood of Glaucoma at the Same Intraocular Pressure in Subjects With Pseudoexfoliation

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Outcome of Raised Intraocular Pressure in Uveitic Eyes With and Without a Corticosteroid-Induced Hypertensive Response

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Recovery of Corneal Hysteresis After Reduction of Intraocular Pressure in Chronic Primary Angle-Closure Glaucoma

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Testability of Vision and Refraction in Preschoolers

The Development of Myopia Among Children With Intermittent Exotropia

Pattern Electroretinogram and Psychophysical Tests of Visual Function for Discriminating Between Healthy and Glaucoma Eyes

Choroidal Neovascularization in Pathologic Myopia: Intravitreal Ranibizumab Versus Bevacizumab—A Randomized Controlled Trial

Primary Retinectomy in Proliferative Vitreoretinopathy

Association Between the Efficacy of Photodynamic Therapy and Indocyanine Green Angiography Findings for Central Serous Chorioretinopathy

Viral Retinitis After Intravitreal Triamcinolone Injection in Patients With Predisposing Medical Comorbidities

Quality of Life in Keratoconus Patients After Penetrating Keratoplasty

Non-Syndromic Supernumerary Caruncles Causing Ocular Irritation After Cataract Surgery: A Critical Review of Caruncular Dysgeneses

Complications and Clinical Outcomes of Descemet Stripping Automated Endothelial Keratoplasty With Intraocular Lens Exchange

Posterior Vitreous Detachment: Evolution and Complications of Its Early Stages

Study Designs in Epidemiology and Levels of Evidence

Current Research in Biostatistics

Central Serous Chorioretinopathy: A Personal Perspective

Peer Review Should Continue After Publication

Contents

Announcement

Reply

Systemic and Local Management at the Onset of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis with Ocular Complications

Reliability and Validity of Abbreviated Surveys Derived from the National Eye Institute Visual Function Questionnaire: The Study of Osteoporotic Fractures

Prognostic Factors of Vitreous Hemorrhage Secondary to Exudative Age-Related Macular Degeneration

Reporting Visual Acuities

Idiopathic Epiretinal Macular Membrane and Cataract Extraction: Combined versus Consecutive Surgery

Serous Retinal Detachment Associated With Retinal Vein Occlusion

Glaucoma Surgery Decreases the Rates of Localized and Global Visual Field Progression

Unfolded Protein Response in Fuchs Endothelial Corneal Dystrophy: A Unifying Pathogenic Pathway?

HLA Typing in Uveitis: Use and Misuse

Bayesian Methods for Data Analysis

Muscle Paths Matter in Strabismus Associated With Axial High Myopia

On the Nature of, and Response to, Medical Evidence

At the Frontier of Vision Research: The National Eye Institute Celebrates 40 Years

Acute Endophthalmitis After Cataract Surgery: 250 Consecutive Cases Treated at a Tertiary Referral Center in the Netherlands

Comparison of Intravitreal Triamcinolone Acetonide With Photodynamic Therapy and Intravitreal Bevacizumab with Photodynamic Therapy for Retinal Angiomatous Proliferation

Protective Effect of Paraoxonase 1 Gene Variant Gln192Arg in Age-Related Macular Degeneration

Paretic Side/Normal Side Ratios of Cross-Sectional Areas of the Superior Oblique Muscle Vary Largely in Idiopathic Superior Oblique Palsy

Retinal Thickness Analysis by Race, Gender, and Age Using Stratus OCT

One-Year Results of Reduced-Fluence Photodynamic Therapy for Polypoidal Choroidal Vasculopathy

Mycophenolate Mofetil for Ocular Inflammation

Long-term Follow-up of Full Macular Translocation for Choroidal Neovascularization

A Simplified Quantitative Method for Assessing Keratoconjunctivitis Sicca From the Sjögren's Syndrome International Registry

Wavefront Analysis, Contrast Sensitivity, and Depth of Focus After Cataract Surgery With Aspherical Intraocular Lens Implantation

Contents

Reply

Spontaneous Corneal Clearance Despite Graft Detachment after Descemet Membrane Endothelial Keratoplasty

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Prospective Comparison of Two Suturing Techniques of Amniotic Membrane Transplantation for Symptomatic Bullous Keratopathy

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Vitreomacular Adhesion in Active and End-Stage Age-Related Macular Degeneration

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Off-Label Use of Drugs and Devices

Reporting Visual Acuities

Spectral-Domain Optical Coherence Tomography: A Comparison of Modern High-Resolution Retinal Imaging Systems

From the Laboratory to the Clinic: Molecular Genetic Testing in Pediatric Ophthalmology

Propensity Score Methods

When Should Anti-Vascular Endothelial Growth Factor Treatment Be Stopped in Age-Related Macular Degeneration?

Are You Compliant With Addressing Glaucoma Adherence?

Management of Acute Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Utilizing Amniotic Membrane and Topical Corticosteroids

Restoration of Photoreceptor Outer Segment after Vitrectomy for Retinal Detachment

Contents

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Low Vision Among Preschool Children in the Beijing Study of Visual Impairment

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Accommodative Loss After Retinal Ablation

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