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British Journal of Ophthalmology

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Anticoagulant and antiplatelet therapy during ocular surgery
We believe that some issues presented in the article by Kiire et al1 need to be corrected, and others deserve some further discussion. Authors in the paragraph on cataract surgery pointed the increased risk of suprachoroidal haemorrhage in patients with high myopia, glaucoma, diabetes, atherosclerotic vascular disease or hypertension referencing to the interesting study,2 which was based only on intracapsular (ICCE) and extracapsular (ECCE) cataract extractions. Both techniques are much more traumatic and are supplemented usually with more invasive than topical form of anaesthesia, however, rarely used today. The dominant ...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Grzybowski, A., Packer, M. Tags: Letters Source Type: research

Authors' response
We thank Grzybowski et al for their comments on our paper.1 The main contention of the authors is that patients undergoing cataract surgery with antiplatelet (Ap) and/or anticoagulant (Ac) medications should continue to receive these drugs based on evidence in the medical literature. In our paper, we clearly acknowledge that the predominant technique for lens extraction is phacoemulsification, and that the risk of complications related to bleeding is rare. In one of the papers2 referenced by Grzybowski et al, a small, but not insignificant, risk of intraoperative haemorrhage in patients undergoing cataract surgery is menti...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Mukherjee, R., Kiire, C. A., Ruparelia, N., Keeling, D., Prendergast, B., Norris, J. H. Tags: Letters Source Type: research

Authors' response: evaluation of choroidal thickness among patients with oculocutaneous albinism
We examined most of the patients during the afternoon (between 12:00 and 17:00) due to logistical availability reasons and this relative limitation of timing might have contributed to the consistency of our results. On the other hand, diurnal variation, as suggested by Chan et al, could have contributed to the difference between choroidal thickness measurements in our study and previous work,4 along with the other possible... (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Karabas, L., Esen, F., Celiker, H., Elcioglu, N., Cerman, E., Eraslan, M., Kazokoglu, H., Sahin, O. Tags: Letters Source Type: research

Evaluation of choroidal thickness among patients with oculocutaneous albinism
We read with interest on the article by Karabas et al1, which reported statistically significant decreased subfoveal choroidal thickness in patients with oculocutaneous albinism (OCA) as compared with age-controlled normal subjects. We would like to congratulate the authors on being the first to describe this among OCA subjects. However, there are relevant factors that we will like to point out. Karabas pointed out that their findings of choroidal thickness among the healthy control population were higher than other studies. Karabas reported subfoveal choroidal thickness of 349±70 µm and 151±31&nbs...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Chan, C. Y., Papakostas, T. D., Vavvas, D. Tags: Letters Source Type: research

Just how old is the modern dacrocystorhinostomy?
Dacrocystorhinostomy—DCR (Gr. αo-o-o-oμα, Dakryon: Tear, Kystis: Bag, Rhis: nose, Stoma: mouth/opening) is a surgical creation of an opening between the lacrimal sac and nasal cavity, or a surgical procedure to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function. If the procedure fails, the option is to then insert a conjunctivo-DCR tube (eg, Lester Jones tube) as a conduit between tear film and nasal passage (figure 1). Current literature identifies Celsus and Galen as some of the earliest physicians to attempt surgical correction of epiphora by a...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Giasin, O., Yeo, D. C. M., Aguirre, A. Tags: Letters Source Type: research

Four haptics are better than two
Removal of the crystalline lens at the time of pars plana vitrectomy surgery is becoming an increasingly common surgical strategy in the management of vitreoretinal disease. Combined surgery provides enhanced peripheral retinal visualisation and the opportunity for a larger gaseous endotamponade and obviates the need for subsequent cataract surgery at a later date.1 These advantages only apply if there are not coexistent disadvantages. One of the reported anterior segment complications of combined surgery is pupillary capture of the lens optic, occurring in 1–2% of all cases.2 This occurs due to an induced pressure g...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Rahman, R., Khan, K. Tags: Letters Source Type: research

Patient perceptions during phacoemulsification cataract surgery: a proposal for routine preoperative patient counselling
Numerous studies have explored the visual perceptions in phacoemulsification cataract surgery.1–3 However, the patient experience is not simply limited to visual perceptions; auditory perceptions (including the phaco machine), facial touch including the flow of water down the face and the presence of a drape, in addition to others, also inevitably contribute to the overall patient experience. We devised a study to explore patient perceptions of routine phacoemulsification cataract surgery and to determine whether presurgical counselling of patients should routinely incorporate this information. Fifty patients undergo...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Khan, M. A., Tang, W. K. S., Tahhan, M. Tags: Letters Source Type: research

Intracameral recombinant tissue plasminogen activator (r-tPA) for refractory toxic anterior segment syndrome
We read an interesting ‘Clinical science’ article by Dotan et al1 entitled ‘Intracameral recombinant tissue plasminogen activator (r-tPA) for refractory toxic anterior segment syndrome’. After studying the manuscript there are some issues that come to mind. First, their prospective study was performed between May 2010 and November 2011. r-tPA was injected into patients who had undergone cataract surgery but whose condition had failed to respond to topical and subconjunctival steroid treatments. It was unclear why such a high number of patients required this treatment in a period as short as 18 ...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Cakmak, H., Kocaturk, T. Tags: Letters Source Type: research

The reliability of parafoveal cone density measurements
Conclusions With the AOSLOs used here, reliable cone density measurements can be obtained between observers and between instruments. Additional work is needed to determine how these results vary with differences in image quality. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Liu, B. S., Tarima, S., Visotcky, A., Pechauer, A., Cooper, R. F., Landsem, L., Wilk, M. A., Godara, P., Makhijani, V., Sulai, Y. N., Syed, N., Yasumura, G., Garg, A. K., Pennesi, M. E., Lujan, B. J., Dubra, A., Duncan, J. L., Carroll, J. Tags: Open access Original articles - Laboratory science Source Type: research

DMEK lenticule preparation from donor corneas using a novel 'SubHyS' technique followed by anterior corneal dissection
Conclusions The DEGs can be preserved in a deturgescent medium for up to 7 days. The procedure provides a standardised, pre-validated (quality assured), pre-separated, no-touch, ready-to-use tissue and also reduces the preparation time. Further, the tissues can be trephined as per the surgeon’s convenience and can either be rolled or a contact lens could be used for final delivery of the DEG using a surgical glide. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Salvalaio, G., Parekh, M., Ruzza, A., Ferrari, S., Camposampiero, D., Ponzin, D. Tags: Ophthalmologic surgical procedures, Epidemiology Original articles - Laboratory science Source Type: research

Upregulation of Toll-like receptor 5 expression in the conjunctival epithelium of various human ocular surface diseases
Conclusions Although TLR5 was normally present on the basal and wing cells of conjunctival epithelium with spatially selective presence, it was expressed on not only the basal and wing cells but also the superficial cells in the conjunctival epithelium of patients with SJS, OCP or chemical eye burns, suggesting that TLR5 might be upregulated in the conjunctival epithelium of these diseases. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Yamada, K., Ueta, M., Sotozono, C., Yokoi, N., Inatomi, T., Kinoshita, S. Tags: Conjunctiva, Ocular surface Original articles - Laboratory science Source Type: research

Timing of congenital dacryostenosis resolution and the development of anisometropia
Conclusions Early spontaneous resolution of dacryostenosis was more likely to have a higher, not lower, rate of anisometropia than late spontaneous or surgical resolution. Further studies are warranted to clarify the relationship between infantile dacryostenosis and the development of hyperopic anisometropia. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Pyi Son, M. K., Hodge, D. O., Mohney, B. G. Tags: Paediatrics, Optic nerve, Optics and refraction Original articles - Clinical science Source Type: research

Intermediate uveitis in children and young adults: differences in clinical course, associations and visual outcome
Conclusions IU with onset in childhood and early adulthood showed a similar visual course at intermediate follow-up. Associated diseases and complication patterns differed between children and young adults. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Heinz, C., Schoonbrood, S., Heiligenhaus, A. Tags: Ciliary body, Lens and zonules, Retina, Neurology Original articles - Clinical science Source Type: research

Sympathetic ophthalmia following diode laser cyclophotocoagulation
Conclusions Sympathetic ophthalmia after diode CPC is rare and is seen in patients with a history of intraocular surgery with or without previous trauma. Early recognition of sympathetic ophthalmia and aggressive management with immunosuppressive therapy results in good outcomes for these patients. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Albahlal, A., Al Dhibi, H., Al Shahwan, S., Khandekar, R., Edward, D. P. Tags: Choroid Original articles - Clinical science Source Type: research

Choroidal schwannoma: a case series of five patients
Conclusions Choroidal schwannoma has a variety of clinical manifestations. Associated features include hard exudates, retinal feeder vessels and serous retinal detachment. Biopsy with immunohistochemistry is required for diagnosis. Tumours not amenable to resection may respond to photodynamic therapy. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Damato, B., Damato, E. M., Konstantinidis, L., Heimann, H., Coupland, S. E. Tags: Retina, Neurology Original articles - Clinical science Source Type: research

The utility of routine tuberculosis screening in county hospital patients with uveitis
Conclusions PPD skin test plays an important role in the diagnosis of TB-associated uveitis in high-risk groups, such as immigrants from TB endemic regions. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Hong, B. K., Khanamiri, H. N., Bababeygy, S. R., Rao, N. A. Tags: Epidemiology Original articles - Clinical science Source Type: research

Decreased subfoveal choroidal thickness and failure of emmetropisation in patients with oculocutaneous albinism
Conclusions This study for the first time demonstrated that CT is decreased in patients with OCA at the subfoveal region. These data combined with the underdevelopment of the foveal pit indicate that there is a generalised developmental or genetic abnormality in the posterior pole of patients with OCA. This choroidal structural abnormality might be related to the previously reported failure of emmetropisation in these children. Further research is needed to understand choroidal metabolism and its relationship with these anatomical changes in albinism. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Karabas, L., Esen, F., Celiker, H., Elcioglu, N., Cerman, E., Eraslan, M., Kazokoglu, H., Sahin, O. Tags: Eye (globe), Editor's choice Original articles - Clinical science Source Type: research

A prospective and nationwide study investigating endophthalmitis following pars plana vitrectomy: clinical presentation, microbiology, management and outcome
Conclusions This study helps surgeons promptly identify cases of endophthalmitis following vitrectomy and informs them about the various management options currently used and the likely outcome of this devastating complication. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Park, J. C., Ramasamy, B., Shaw, S., Ling, R. H. L., Prasad, S., Foot, Belam, Hutchings, Frimpong-Ansah, Raman, Doyle, James, Cole, Sheehan, Charles, Ho, Yorston, Awan, MacLaren, Patel, Rosen, Fletcher, Membrey, Muthiah, Price, Chalioulias, Mahomed, Toor, Tags: Ophthalmologic surgical procedures, Choroid, Eye (globe), Neurology, Epidemiology Original articles - Clinical science Source Type: research

Cone photoreceptor definition on adaptive optics retinal imaging
Conclusions Imaging data acquired from the AO camera match cone density, intercone distance and show the known features of cone photoreceptor distribution in the pericentral retina as reported by histology, namely, decreasing density values from 2 to 7° of eccentricity and the hexagonal packing arrangement. This confirms that AO flood imaging provides reliable estimates of pericentral cone photoreceptor distribution in normal subjects. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Muthiah, M. N., Gias, C., Chen, F. K., Zhong, J., McClelland, Z., Sallo, F. B., Peto, T., Coffey, P. J., da Cruz, L. Tags: Open access Original articles - Clinical science Source Type: research

Small retinal haemorrhages accompanied by macular soft drusen: prevalence, and funduscopic and angiographic characteristics
Conclusions The presence of small retinal haemorrhages accompanied by macular soft drusen was highly predictive of RAP. The high prevalence of both soft drusen and reticular pseudodrusen in these eyes may suggest a profound decrease in choroidal perfusion in these eyes. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Kim, J. H., Lee, T. G., Kim, J. W., Kim, C. G., Cho, S. W., Han, J. I. Tags: Retina Original articles - Clinical science Source Type: research

Factors predictive of long-term visual outcomes of Group D eyes treated with chemoreduction and low-dose IMRT salvage: The Children's Hospital Los Angeles experience
Conclusions At presentation, it is difficult to predict which Group D eyes will be salvaged with useful vision following systemic chemotherapy. The presence of complete retinal detachment, macular involvement and extensive seeding on presentation were factors associated with a worse visual prognosis in this study. These findings can guide the ophthalmologist in clinical decision making, as well as in counselling parents. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Berry, J. L., Jubran, R., Wong, K., Lee, T. C., Murphree, A. L., Kim, J. W. Tags: Public health, Retina Original articles - Clinical science Source Type: research

Outcome and quality of screening in a nationwide survey on retinopathy of prematurity in The Netherlands
Conclusions The incidence of severe ROP and infants treated was low. NEDROP emphasises that timing of initial examination and transfer to another hospital are issues of concern within the screening process. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: van Sorge, A. J., Termote, J. U. M., Simonsz, H. J., Kerkhoff, F. T., van Rijn, L. J., Lemmens, W. A. J. G., Schalij-Delfos, N. E. Tags: Retina, Epidemiology Original articles - Clinical science Source Type: research

A systematic correlation of morphology and function using spectral domain optical coherence tomography and microperimetry in patients with geographic atrophy
Conclusions Mapping retinal sensitivity to distinct retinal pathologies revealed outer retinal layers, in addition to the RPE, as significant for sensitivity loss. Therefore in GA the RPE loss and the alteration of outer retinal layers should be analysed, which could also provide insight into lesion progression. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Sayegh, R. G., Kiss, C. G., Simader, C., Kroisamer, J., Montuoro, A., Mittermuller, T. J., Azhary, M., Bolz, M., Kreil, D. P., Schmidt-Erfurth, U. Tags: Vision, Neurology Original articles - Clinical science Source Type: research

Improving the cost-effectiveness of photographic screening for diabetic macular oedema: a prospective, multi-centre, UK study
Conclusions Retinal screening programmes in the UK should reconsider the screening pathway to make best use of existing and new technologies. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Prescott, G., Sharp, P., Goatman, K., Scotland, G., Fleming, A., Philip, S., Staff, R., Santiago, C., Borooah, S., Broadbent, D., Chong, V., Dodson, P., Harding, S., Leese, G., Megaw, R., Styles, C., Swa, K., Wharton, H., Olson, J. Tags: Retina, Epidemiology Original articles - Clinical science Source Type: research

12-month results of the standardised combination therapy for diabetic macular oedema: intravitreal bevacizumab and navigated retinal photocoagulation
Conclusions Standardised combination therapy using bevacizumab injections followed by navigated laser treatment for clinically significant diabetic macular oedema demonstrated significant visual gain and CRT reduction after bevacizumab treatment and stabilisation after navigated laser up to 12 months. The number of injections required in 12 months was lower than reported in previous combination studies. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Barteselli, G., Kozak, I., El-Emam, S., Chhablani, J., Cortes, M. A., Freeman, W. R. Tags: Ophthalmologic surgical procedures, Retina, Open access Original articles - Clinical science Source Type: research

Collagen crosslinking in the management of advanced non-resolving microbial keratitis
Conclusions CXL appears to be an effective procedure in the management of superficial microbial keratitis. It can be used as an adjunctive treatment in the management of non-resolving microbial keratitis. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Shetty, R., Nagaraja, H., Jayadev, C., Shivanna, Y., Kugar, T. Tags: Cornea, Eye (globe), Ocular surface, Neurology Original articles - Clinical science Source Type: research

Descemet's stripping automated endothelial keratoplasty with anterior chamber intraocular lenses: complications and 3-year outcomes
Conclusions We found that although eyes with BK and ACIOL that underwent DSAEK while retaining the ACIOL suffered EC loss which was not significantly greater at 1 year, EC loss and graft survival were significantly poorer compared to DSAEK controls at 3 years postoperatively. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Ang, M., Li, L., Chua, D., Wong, C., Htoon, H. M., Mehta, J. S., Tan, D. Tags: Ophthalmologic surgical procedures, Cornea, Ocular surface, Epidemiology Original articles - Clinical science Source Type: research

Therapeutic effects of 0.1% tacrolimus eye drops for refractory allergic ocular diseases with proliferative lesion or corneal involvement
Conclusions Tacrolimus eye drops are highly effective in treating refractory allergic conjunctivitis with proliferative lesions and/or corneal involvement, and may reduce or replace topical steroid use. Trial registration number UMIN 000008640. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Fukushima, A., Ohashi, Y., Ebihara, N., Uchio, E., Okamoto, S., Kumagai, N., Shoji, J., Takamura, E., Nakagawa, Y., Namba, K., Fujishima, H., Miyazaki, D. Tags: Conjunctiva, Ocular surface, Open access Original articles - Clinical science Source Type: research

Systematic review of randomised clinical trials on topical ciclosporin A for the treatment of dry eye disease
Conclusions Although topical CsA appears to be a safe treatment for DED, evidence emerging from RCTs is limited, and this affects the strength of recommendations to healthcare providers and policymakers for optimal management. Standardised diagnostic criteria to assess the efficacy of topical CsA are recommended to improve the design of future RCTs in DED. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Sacchetti, M., Mantelli, F., Lambiase, A., Mastropasqua, A., Merlo, D., Bonini, S. Tags: Public health Original articles - Clinical science Source Type: research

Photobiomodulation in the treatment of patients with non-center-involving diabetic macular oedema
Conclusions PBM potentially offers a non-invasive and cost-effective therapeutic option for patients with NCDME. Further studies of this therapeutic option in DR are warranted (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Tang, J., Herda, A. A., Kern, T. S. Tags: Retina Innovations Source Type: research

Willingness to use follow-up eye care services after vision screening in rural areas surrounding Chennai, India
Conclusions Maintaining consistent quality of services delivered is crucial for increasing uptake of existing eye care services. Educational interventions may increase eye care service usage by targeting all demographic subgroups of rural populations equally. Additional interventions should be offered to patients without previous exposure to the healthcare system. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Su, Z., Wang, B. Q., Staple-Clark, J. B., Buys, Y. M., Forster, S. H. Tags: Public health, Epidemiology Global issues Source Type: research

Reporting of harms by randomised controlled trials in ophthalmology
To evaluate the reporting of harms by randomised controlled trials investigating intravitreal therapies for diabetic macular oedema. A thorough literature search identified eligible reports. Two authors independently extracted data from these articles using a prospectively created checklist. The main outcome measure was compliance with the 10 recommendations of the 2004 Consolidated Standards of Reporting Trials statement extension for better harms reporting. Secondary outcomes were the predictors of the number of recommendations met and the amount of space devoted to harms reporting. Thirty-six reports involving 7246 eyes...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: O'Day, R., Walton, R., Blennerhassett, R., Gillies, M. C., Barthelmes, D. Tags: Review Source Type: research

Topical cyclosporine: are all indications justified?
Inflammation is involved in the pathogenic mechanism of most of the chronic ocular surface disorders. In fact, the ocular surface can be considered as an ‘immunological’ unit that works with the aim to protect the visual system from external and internal noxae. This exposes the ocular surface structures to a continuous, subclinical, inflammatory condition. In this way, the ocular surface acts as an anatomical and functional unit that maintains a controlled immunological protection against several stimuli, such as allergens, chemical or physical irritants, traumas and infections from the external environment. No...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Aragona, P. Tags: Editorials Source Type: research

To Be or not TB?
Relative to other specialties, ophthalmologists deal infrequently with uncertainty. Of course, every patient requires advice, which in turns requires a weighing of risks and benefits, and some pondering of potential unknowns. But unlike internists, ophthalmologists often see the pathology directly. And what once was hidden from us is now rapidly being revealed with new technologies like optical coherence tomography and adaptive optics. Within the ophthalmic kingdom, however, some subspecialties deal with more uncertainty than others. Specialists in uveitis, in particular, often confront uncertainty. Is the pathology autoim...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Rosenbaum, J. T. Tags: Choroid, Eye (globe), Epidemiology Editorials Source Type: research

Highlights from this issue
In this August issue of the BJO, Sacchetti and colleagues performed a meta-analysis of previously published randomized controlled trials on the topical use of cyclosporine A for the therapy of dry eyes.1 They found that all cyclosporine A formulations proved safe for the treatment of dry eye disease, and that symptoms improved in 9 out of 9 trials, while tear function improved in 13 out of 18 studies. Topical therapy with cyclosporine A was not successful for dry eye disorders resulting from surgical procedures, contact lens use and thyroid orbitopathy. The authors concluded that although topical cyclosporine A was safe tr...
Source: British Journal of Ophthalmology - July 18, 2014 Category: Opthalmology Authors: Barton, K., Jonas, J. B., Chodosh, J. Tags: At a glance Source Type: research

Polypoidal choroidal vasculopathy in Caucasian patients with presumed age-related macular degeneration
In this study, the authors included patients who were evaluated with ICGA only after receiving ≥8 ranibizumab injections. Prior to evaluation with ICGA, the patients who were eventually diagnosed with PCV had received a mean of 6.7±3.1 ranibizumab... (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Tan, C. S., Ngo, W. K., Cheong, K. X., Lim, T. H. Tags: Letters Source Type: research

Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study
Actually we used two survival analyses in the paper:1 a Kaplan–Meier (KM) plot with log-rank test (figure 1), and stratified Cox regression (table 2). Among the 815 cases and 4075 controls, 41 cases and 164 controls had pre-coronary heart disease (CHD). In the KM analysis, we excluded only those with pre-CHD, and the corresponding (unadjusted) p value from log-rank test for central serous chorioretinopathy (CSCR) is 0.002. However, in stratified Cox regression, we did exclude 41 cases along with their fivefold matched controls (as stated in the legend of figure 1, 774 cases and 3870 controls were used), and came out ...
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Chen, S.-N., Lian, I. Tags: Letters Source Type: research

Swept-source optical coherence tomography imaging of the cortical vitreous and the vitreoretinal interface in proliferative diabetic retinopathy: assessment of vitreoschisis, neovascularisation and the internal limiting membrane
Anomalous posterior vitreous detachment leads to shrinkage of the inner vitreous with the outer precortical vitreous cortex remaining attached to the macula and retina, resulting in vitreoschisis.1 Sebag and coworkers have reported vitreoschisis in macular disorders, and vitreoschisis has been demonstrated using ultrasonography and histopathology.2–4 Swept-source OCT (SS-OCT) is a new imaging technology (Atlantis DRI-OCT-1, Topcon, Japan). We demonstrate for the first time in vivo the microstructural tomographic features of and spatial vitreoretinal relationships between vitreoschisis, retinal and optic nerve head ne...
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Muqit, M. M. K., Stanga, P. E. Tags: Letters Source Type: research

High-frequency ultrasound-guided transscleral diode laser cyclophotocoagulation
Introduction Coagulation of the ciliary body via transscleral diode laser cyclophotocoagulation (cyclodiode) of the ciliary body is a therapeutic option for numerous types of glaucoma. It is commonly used in patients with refractory glaucoma for a temporising effect prior to drainage procedures, as an adjunct to surgery, in patients who are precluded from undergoing general anaesthesia, or in individuals who have no visual potential and need pain relief.1 Typically, the probe is applied to a point corresponding to the pars plicata of the ciliary body. This has been historically identified as 1–2 mm behind the li...
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Way, A. L., Nischal, K. K. Tags: Letters Source Type: research

Blue light injures corneal epithelial cells in the mitotic phase in vitro
Introduction Blue light is a part of the visible light spectrum in the wavelength range of 390–490 nm. In modern society, light-emitting diode lamps and computer displays deliver much more blue light to the cornea than ever before. The retinal phototoxicity of blue light has been extensively investigated because of concerns about macular degeneration.1 2 The effects of blue light on the health of the ocular surface are less clear.3 4 Like skin,5 the ocular surface is directly exposed to visible blue light and this contributes to photophobia and ocular pain.6 We have carried out culture experiments to examine the...
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Niwano, Y., Kanno, T., Iwasawa, A., Ayaki, M., Tsubota, K. Tags: Letters Source Type: research

Are worldwide albinism prevalence figures an accurate reflection? An incidental finding from a Northern Ireland study
Person et al,1 and Witkop et al,2 suggest global prevalence figures for albinism of 1 in 20 000 and 1 in 17 000, respectively. Person et al's1 figure is widely quoted in the literature but it is unclear how it was derived. Grønskov et al,3 investigated birth prevalence and mutation spectrum in Danish patients with autosomal recessive albinism suggesting a minimum birth prevalence of 1 in 14 000. Similarly Froggatt4 had investigated the occurrence of albinism in Northern Ireland (NI) in 1960 and reported a prevalence of 1 in 10 000. Clearly there are discrepancies in the literature in terms o...
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Healey, N., McLoone, E., Saunders, K. J., Jackson, A. J., McClelland, J. F. Tags: Letters Source Type: research

Evidence of early ultrastructural photoreceptor abnormalities in light-induced retinal degeneration using spectral domain optical coherence tomography
Conclusions Longitudinal SD-OCT reveals intraretinal changes that cannot be observed by histopathology at early time points in the light injury model. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Aziz, M. K., Ni, A., Esserman, D. A., Chavala, S. H. Tags: Retina Original articles - Laboratory science Source Type: research

Osteo-odonto-keratoprosthesis (OOKP) and the testing of three different adhesives for bonding bovine teeth with optical poly-(methyl methacrylate) (PMMA) cylinder
Conclusions Excellent bonding strength combined with easy application was found for universal resin cement, and thus, it is a potential alternative to acrylic bone cement in OOKP preparation. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Weisshuhn, K., Berg, I., Tinner, D., Kunz, C., Bornstein, M. M., Steineck, M., Hille, K., Goldblum, D. Tags: Original articles - Laboratory science Source Type: research

Change in choroidal thickness and axial length with change in intraocular pressure after trabeculectomy
Conclusions The dynamic relationship between change in IOP and the state of sclera and choroid was confirmed by sequential measurements in postoperative trabeculectomy patients, providing estimates of the magnitude of choroidal swelling and scleral volume decrease with IOP lowering. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Saeedi, O., Pillar, A., Jefferys, J., Arora, K., Friedman, D., Quigley, H. Tags: Ophthalmologic surgical procedures, Optic nerve, Optics and refraction Original articles - Clinical science Source Type: research

Enhanced depth imaging optical coherence tomography of the choroid in migraine patients: implications for the association of migraine and glaucoma
Conclusions Choroidal thickness was found to be significantly increased in migraine patients during the attack period when compared to basal levels. The possible implications of this finding on the association between migraine and glaucoma are discussed. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Dadaci, Z., Doganay, F., Oncel Acir, N., Aydin, H. D., Borazan, M. Tags: Angle, Intraocular pressure, Neurology, Glaucoma, Epidemiology Original articles - Clinical science Source Type: research

Does choroidal melanoma regression correlate with chromosome 3 loss after ruthenium brachytherapy?
Conclusions The rate of choroidal melanoma regression after ruthenium-106 brachytherapy does not appear to correlate with chromosome 3 loss, suggesting that tumour thickness reduction 6 months after treatment is unlikely to predict survival. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Chiam, P. J. T., Coupland, S. E., Kalirai, H., Groenewald, C., Heimann, H., Damato, B. E. Tags: Public health Original articles - Clinical science Source Type: research

WINROP can modify ROP screening praxis: a validation of WINROP in populations in Sormland and Vastmanland
Conclusions WINROP identified all the infants at risk for developing stage 3 ROP (100% sensitivity) and had a 59% specificity. The alarm was registered several weeks before screening for ROP began. WINROP can be used to complement conventional ROP screening. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Eriksson, L., Liden, U., Lofqvist, C., Hellstrom, A. Tags: Retina, Epidemiology Original articles - Clinical science Source Type: research

Desegmentation of Ozurdex implant in vitreous cavity: report of two cases
Conclusions With more and more microsurgical implantation procedures, clinicians should be well aware of these unusual although rare complications. Even though the desegmented implants do not appear to cause more intraocular complications compared with single-piece implants, patients with defragmented implants should be followed up carefully to monitor for unexpected complications. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Agrawal, R., Fernandez-Sanz, G., Bala, S., Addison, P. K. F. Tags: Original articles - Clinical science Source Type: research

Long-term results of intravitreal ranibizumab for the treatment of retinal angiomatous proliferation and utility of an advanced RPE analysis performed using spectral-domain optical coherence tomography
Conclusions The intravitreal injection of ranibizumab was effective for stabilising vision in patients with RAP, as evaluated at a 3-year follow-up examination. Advanced RPE analysis is useful for investigating atrophic areas after IVR. Visual acuity at baseline and progression of MA might be important for BCVA after IVR. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Inoue, M., Arakawa, A., Yamane, S., Kadonosono, K. Tags: Original articles - Clinical science Source Type: research

Aflibercept treatment for patients with exudative age-related macular degeneration who were incomplete responders to multiple ranibizumab injections (TURF trial)
Conclusions Aflibercept 2.0 mg treatment maintained mean visual acuity improvements previously achieved with high-dose 2.0-mg ranibizumab injections in recalcitrant wet AMD patients. Aflibercept 2.0 mg treatment led to significant anatomic improvement and was required monthly in most patients. Clinical Trials Registration FDA IND#12462. NCT 01543568. Trial Details IND 12462, NCT 01543568 http://clinicaltrials.gov/show/NCT01543568. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - June 12, 2014 Category: Opthalmology Authors: Wykoff, C. C., Brown, D. M., Maldonado, M. E., Croft, D. E. Tags: Retina, Open access Original articles - Clinical science Source Type: research