Ultrastructural study of peripheral and central stroma of keratoconus cornea
Purpose Assess the lamellar organisation of the peripheral and central stroma of the keratoconus (KC) and normal cornea. Methods Five normal and three KC corneas were fixed in 2.5% glutaraldehyde and processed for electron microscopy. The ultrathin sections were observed under JEOL 1400 TEM, and digital images were taken with a bottom-mounted 11-megapixel Quamisa camera, using the iTEM software. Measurements of the lamellae were carried out using the iTEM software. Statistical analysis was performed using the SPSS software. Results The lamellar organisation at the centre and periphery of the KC cornea was disrupted by th...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Alkanaan, A., Barsotti, R., Kirat, O., Almubrad, T., Khan, A., Akhtar, S. Tags: Original articles - Laboratory science Source Type: research

The natural history of corneal topographic progression of keratoconus after age 30 years in non-contact lens wearers
Background/aims To determine if significant progression of disease occurs in older, non-contact lens wearing, subjects with keratoconus and to identify potential predictive factors. Methods Clinical and computerised corneal topography records of subjects with keratoconus attending a specialist optometry practice were retrospectively analysed to identify those aged ≥30 years, with ≥2 consultations ≥12 months apart, no contact lens wear and no corneal scarring, surgery or corneal hydrops. Topographic parameters assessed included: maximum keratometry (Kmax), steep keratometry (Ksteep), flat keratometry (Kf...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Gokul, A., Patel, D. V., Watters, G. A., McGhee, C. N. J. Tags: Cornea, Lens and zonules, Ocular surface Original articles - Clinical science Source Type: research

New Zealand trends in corneal transplantation over the 25 years 1991-2015
Conclusion Changing indications and increasing uptake of lamellar keratoplasty have been significant international trends over the last 25 years. However, New Zealand's corneal disease and population characteristics create unique longitudinal trends, with keratoconus remaining the leading indication and penetrating keratoplasty the leading technique from 1991 to 2015. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Kim, B. Z., Meyer, J. J., Brookes, N. H., Moffatt, S. L., Twohill, H. C., Pendergrast, D. G., Sherwin, T., McGhee, C. N. J. Tags: Ophthalmologic surgical procedures, Cornea, Ocular surface Original articles - Clinical science Source Type: research

Outcome of allo simple limbal epithelial transplantation (alloSLET) in the early stage of ocular chemical injury
Conclusions AlloSLET seems to be a useful technique to achieve rapid epithelialisation in severe chemical injuries thereby preventing the adverse effects of delayed epithelial healing. Visual rehabilitative procedures in the chronic phase of chemical injury, in most instances following an alloSLET in the acute stage, did not require keratoplasty, either lamellar or penetrating. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Iyer, G., Srinivasan, B., Agarwal, S., Tarigopula, A. Tags: Ophthalmologic surgical procedures Original articles - Clinical science Source Type: research

Optimising keratoplasty for Peters' anomaly in infants using spectral-domain optical coherence tomography
Purpose To present in vivo anterior segment optical coherence tomography (OCT) features of infants with Peters' anomaly obtained during presurgical examination under general anaesthesia, and to evaluate the impact of OCT features on surgical decision making. Methods This is a single-centre, consecutive, observational case series including 44 eyes of 27 infants with Peters' anomaly (5–18 months) undergoing keratoplasty. Medical records of patients were reviewed retrospectively. Clinical features and OCT findings, along with their impact on surgical decision-making were analysed. Results Of 27 patients, 10 had u...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Hong, J., Yang, Y., Cursiefen, C., Mashaghi, A., Wu, D., Liu, Z., Sun, X., Dana, R., Xu, J. Tags: Paediatrics, Ophthalmologic surgical procedures, Cornea, Lens and zonules, Ocular surface Original articles - Clinical science Source Type: research

Transcutaneous periorbital electrical stimulation in the treatment of dry eye
Purpose To evaluate efficacy and safety of transcutaneous application of electrical current on symptoms and clinical signs of dry eye (DE). Methods 27 patients with DE underwent transcutaneous electrostimulation with electrodes placed onto the periorbital region of both eyes and manual stimulation with a hand-piece conductor moved by the operator. Each patient underwent 12 sessions of 22 min spread over 2 months, two sessions per week in the first month and one session per week in the second month. Ocular Surface Disease Index (OSDI) questionnaire, tear break-up time (TBUT), fluorescein staining of the cornea, S...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Pedrotti, E., Bosello, F., Fasolo, A., Frigo, A. C., Marchesoni, I., Ruggeri, A., Marchini, G. Tags: Original articles - Clinical science Source Type: research

Characteristics and variations of in vivo Schlemm's canal and collector channel microstructures in enhanced-depth imaging optical coherence tomography
Background/aims To characterise in vivo Schlemm's canal (SC) and collector channels (CC) microstructures using enhanced-depth imaging (EDI) optical coherence tomography (OCT). Methods Serial horizontal EDI OCT B-scans (81 scans, 15x5° rectangle) were prospectively obtained in the nasal and temporal limbus. SC cross-sectional area (CSA) was measured by delineating its lumen in each B-scan. CCs connected to SC were counted. SC CSA and the number of CCs were compared between the nasal and temporal areas. Results Eleven eyes (11 normal subjects) were included (mean age, 28±5 years). SC and CCs were clearly de...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Li, P., Butt, A., Chien, J. L., Ghassibi, M. P., Furlanetto, R. L., Netto, C. F., Liu, Y., Kirkland, W., Liebmann, J. M., Ritch, R., Park, S. C. Tags: Original articles - Clinical science Source Type: research

Treatment patterns and medication adherence of patients with glaucoma in South Korea
Conclusion Approximately, one-third of the patients were non-adherent, and males and increased daily number of administration were associated with non-adherence. It highlights that more systematic treatment strategies should be considered for better medication adherence, leading to effective glaucoma management. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Kim, C. Y., Park, K. H., Ahn, J., Ahn, M.-D., Cha, S. C., Kim, H. S., Kim, J. M., Kim, M. J., Kim, T.-W., Kim, Y. Y., Lee, J. W., Park, S.-W., Sohn, Y. H., Sung, K. R., Yoo, C., Cha, J., Kim, Y.-J. Tags: Open access Original articles - Clinical science Source Type: research

Ocular hypotensive effect of the novel EP3/FP agonist ONO-9054 versus Xalatan: results of a 28-day, double-masked, randomised study
This study compared the novel dual EP3/FP agonist ONO-9054 with the FP agonist Xalatan. Methods Adults (n=123) with bilateral mild/moderate OAG or OHT, with unmedicated IOP of ≥24 mm Hg at 8:00 hours, ≥21 mm Hg at 10:00 hours and ≤36 mm Hg, were randomised 1:1 to receive ONO-9054 (0.003%, 30 μg/mL) or Xalatan (0.005%, 50 μg/mL) once daily for 28 days. Results Day 29 mean diurnal IOP was –7.2 mm Hg for ONO-9054 vs –6.6 mm Hg for Xalatan. At 08:00 hours, the IOPs were comparable, and at all later time points the decrease in IOP...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Miller Ellis, E., Berlin, M. S., Ward, C. L., Sharpe, J. A., Jamil, A., Harris, A. Tags: Angle, Intraocular pressure, Open access, Glaucoma Original articles - Clinical science Source Type: research

Morphological and functional changes in recalcitrant diabetic macular oedema after intravitreal dexamethasone implant
Background To evaluate the effects of dexamethasone implant in eyes affected by recalcitrant diabetic macular oedema (DME) associated with proliferative diabetic retinopathy (PDR). Methods Thirteen consecutive patients with centre-involving DME associated with PDR, central macular thickness (CMT) ≥300 µm, previous therapy with panretinal photocoagulation, focal/grid laser treatment and anti-vascular endothelial growth factor injection were prospectively enrolled. A complete ophthalmological examination included: best-corrected visual acuity (BCVA) assessment, spectral-domain optical coherence tomography and ...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Iacono, P., Parodi, M. B., Scaramuzzi, M., Bandello, F. Tags: Ophthalmologic surgical procedures, Retina Original articles - Clinical science Source Type: research

Changes in subfoveal choroidal thickness and reduction of serum levels of vascular endothelial growth factor in patients with POEMS syndrome
Conclusions The significant correlation between the CT and the serum level of VEGF may offer clues on the pathogenesis of ocular diseases of POEMS syndrome and on the role of serum VEGF on the choroid. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Yokouchi, H., Baba, T., Misawa, S., Kitahashi, M., Oshitari, T., Kuwabara, S., Yamamoto, S. Tags: Neurology Original articles - Clinical science Source Type: research

Vascular abnormalities in patients with Stargardt disease assessed with optical coherence tomography angiography
Aims To describe the vascular abnormalities in patients affected by Stargardt disease (STGD1) by means of optical coherence tomography angiography (OCT-A). Methods Cross-sectional case series, with the following inclusion criteria: diagnosis of STGD1, clear ocular media, and stable fixation. Patients underwent best-corrected visual acuity (BCVA), biomicroscopy, applanation tonometry, short-wavelength fundus autofluorescence (SW-FAF) (HRA Heidelberg, Germany), 3x3 Swept Source OCT-A (Topcon Corporation, Japan). Foveal avascular zone (FAZ) area was manually outlined and removed from the vessel density analysis (ImageJ). Mai...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Battaglia Parodi, M., Cicinelli, M. V., Rabiolo, A., Pierro, L., Bolognesi, G., Bandello, F. Tags: Retina Original articles - Clinical science Source Type: research

Association between outer retinal alterations and microvascular changes in intermediate stage age-related macular degeneration: an optical coherence tomography angiography study
Aims To investigate associations between changes in retinal vessels and alterations detected by spectral domain optical coherence tomography (SD-OCT) scans in intermediate stage age-related macular degeneration (AMD). Methods Thirty eyes of 30 patients with intermediate dry AMD were enrolled in the study. Of the cohort study, 15 eyes (changes-AMD group) showed OCT changes preceding the development of drusen-associated atrophy. A control group of healthy subjects was selected for statistical comparisons. All patients underwent an ophthalmologic evaluation, including OCT angiography (OCTA) and SD-OCT scans. Main outcome mea...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Toto, L., Borrelli, E., Mastropasqua, R., Di Antonio, L., Doronzo, E., Carpineto, P., Mastropasqua, L. Tags: Retina, Epidemiology Original articles - Clinical science Source Type: research

Pilot evaluation of short-term changes in macular pigment and retinal sensitivity in different phenotypes of early age-related macular degeneration after carotenoid supplementation
Purpose To investigate the response of carotenoid supplementation in different phenotypes of early age-related macular degeneration (AMD) by measuring macular pigment optical density (MPOD) and retinal sensitivity. Methods Consecutive patients with only medium/large drusen and only reticular pseudodrusen (RPD) and age-matched and sex-matched controls were enrolled. At baseline, participants underwent a complete ophthalmological examination including measurement of best-corrected visual acuity (BCVA), MPOD and retinal sensitivity. Patients were put on vitamin supplementation (lutein 10 mg/day, zeaxanthin 2 mg/day...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Corvi, F., Souied, E. H., Falfoul, Y., Georges, A., Jung, C., Querques, L., Querques, G. Tags: Retina Original articles - Clinical science Source Type: research

Choroidal thickness in non-neovascular versus neovascular age-related macular degeneration: a fellow eye comparative study
Conclusions Subfoveal and temporal choroid was significantly thicker in NNV AMD compared with NV AMD fellow eyes. There was a significant choroidal thinning at advanced stages of NNV AMD. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Govetto, A., Sarraf, D., Figueroa, M. S., Pierro, L., Ippolito, M., Risser, G., Bandello, F., Hubschman, J. P. Tags: Retina Original articles - Clinical science Source Type: research

Short-term efficacy of intravitreal aflibercept depending on angiographic classification of polypoidal choroidal vasculopathy
Conclusions There was a difference in early treatment response with aflibercept between two subtypes of PCV. Type 1 polypoidal CNV showed better visual improvement with a higher percentage of polyp regression than type 2 idiopathic PCV. Trial registration number NCT02597855, Results. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Jeong, S., Sagong, M. Tags: Choroid Original articles - Clinical science Source Type: research

Lack of differences in the regional variation of oxygen saturation in larger retinal vessels in diabetic maculopathy and proliferative diabetic retinopathy
Conclusions The regional differences in retinal lesions in vision threatening diabetic retinopathy are not reflected in regional differences in the oxygen saturation of larger retinal vessels. The development of vision threatening diabetic retinopathy depends on other factors, such as, for example, regional differences in the retinal microcirculation. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Jorgensen, C. M., Bek, T. Tags: Retina Original articles - Clinical science Source Type: research

Episcleral brachytherapy of uveal melanoma: role of intraoperative echographic confirmation
Conclusions Intraoperative echographic confirmation of plaque placement during episcleral brachytherapy for choroidal melanoma reduces the risk of early local recurrence. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Aziz, H. A., Al Zahrani, Y. A., Bena, J., Lorek, B., Wilkinson, A., Suh, J., Singh, A. D. Tags: Eye (globe) Original articles - Clinical science Source Type: research

Maximal levator resection in unilateral congenital ptosis with poor levator function
Conclusions Maximal levator resection is an effective procedure for congenital ptosis even in patients with poor levator function, which provides improved cosmesis, a more natural lid contour, and avoids brow scars. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Lee, J.-H., Aryasit, O., Kim, Y.-D., Woo, K. I., Lee, L., Johnson, O. N. Tags: Cornea, Eye Lids, Ocular surface Original articles - Clinical science Source Type: research

Trends over time in the incidence of congenital anophthalmia, microphthalmia and orbital malformation in England: database study
Conclusions The incidence of these conditions has remained stable in England in recent years. Although the incidence of microphthalmia was stable, hospital admission rates for it increased over time reflecting an increase in multiple admissions per affected person. These data may be useful for planning service provision. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Dharmasena, A., Keenan, T., Goldacre, R., Hall, N., Goldacre, M. J. Tags: Original articles - Clinical science Source Type: research

Long-term functional results following vitrectomy for advanced retinopathy of prematurity
Conclusions Surgery for stage 4A ROP has better visual success. Acceptable vision for stage 4B and poor for stage 5 ROP, despite retinal reattachment, is thought to be secondary to irreversible injury to either the retina or visual nervous pathways, or both. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Karacorlu, M., Hocaoglu, M., Sayman Muslubas, I., Arf, S. Tags: Paediatrics, Ophthalmologic surgical procedures, Retina Original articles - Clinical science Source Type: research

Prevalence and predictors of metamorphopsia after successful rhegmatogenous retinal detachment surgery: a cross-sectional, comparative study
Aims To evaluate the prevalence of metamorphopsia after successful rhegmatogenous retinal detachment (RRD) surgery and determine the independent predictors of metamorphopsia. Methods A cross-sectional, comparative study. The study included 380 eyes of 357 patients who underwent a successful RRD surgery between 2009 and 2015. The presence of metamorphopsia was tested with an Amsler grid and the foveal microstructure was scanned with high-resolution spectral-domain optical coherence tomography (OCT) at a follow-up visit. Medical records were reviewed for preoperative and intraoperative factors associated with postoperative ...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Zhou, C., Lin, Q., Chen, F. Tags: Retina Original articles - Clinical science Source Type: research

The role of internal limiting membrane peeling in epiretinal membrane surgery: a randomised controlled trial
Conclusions Our analysis suggests that ILM peeling in idiopathic ERM surgery does not result in better visual improvement. The more frequent presence of an uninterrupted interdigitation zone in the P group did not result in a better functional outcome of our patients. No recurrent ERMs were noted in either group. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Tranos, P., Koukoula, S., Charteris, D. G., Perganda, G., Vakalis, A., Asteriadis, S., Georgalas, I., Petrou, P. Tags: Retina, Epidemiology Original articles - Clinical science Source Type: research

Vitrectomy with and without encircling band for pseudophakic retinal detachment: VIPER Study Report No 2--main results
Conclusions Vitrectomy with gas is an efficient and safe treatment for uncomplicated PRD. An additional encircling band does not significantly reduce the risk for any second procedure necessary to reattach the retina in 20 G vitrectomy. Small gauge transconjunctival vitrectomy is not inferior to the conventional 20 G technique. Trial registration number DKRS 00003158, Results. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Walter, P., Hellmich, M., Baumgarten, S., Schiller, P., Limburg, E., Agostini, H., Pielen, A., Helbig, H., Lommatzsch, A., Rössler, G., Mazinani, B., for the VIPER Study Group, Junker, Ness, Joussen, Aisenbrey, Partsch, Bartz-Schmidt, Holz, Kirchh Tags: Ophthalmologic surgical procedures, Retina, Open access Original articles - Clinical science Source Type: research

Cataracts induced by neodymium-yttrium-aluminium-garnet laser lysis of vitreous floaters
Conclusions Secondary cataract formation accompanied by loss of integrity of the posterior capsule is a potential complication of Nd:YAG laser vitreolysis for symptomatic floaters. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Koo, E. H., Haddock, L. J., Bhardwaj, N., Fortun, J. A. Tags: Ophthalmologic surgical procedures, Lens and zonules Original articles - Clinical science Source Type: research

"The patient is speaking": discovering the patient voice in ophthalmology
Eye disease can be devastating. The most feared impact is sight loss, but in a number of ophthalmic conditions, there can be wide-ranging systemic, psychological, emotional and social effects of both the disease and its treatment. External tests of visual function, such as visual acuity, are inadequate to understand the overall impact of ophthalmic disease on a patient’s functional vision or daily life. This can lead to a discordance between the patient’s priorities and perspective on the one hand and the efforts of clinicians and other stakeholders on the other hand. In this review, we discuss how the patient ...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Dean, S., Mathers, J. M., Calvert, M., Kyte, D. G., Conroy, D., Folkard, A., Southworth, S., Murray, P. I., Denniston, A. K. Tags: Open access Review Source Type: research

Automated quantitative characterisation of retinal vascular leakage and microaneurysms in ultra-widefield fluorescein angiography
In this report, we describe a novel fully automated software platform, which segments MAs and leakage areas in native and dewarped UWFA images with retinal vascular disease. Comparison of the algorithm with human grader-generated gold standards demonstrated significant strong correlations for MA and leakage areas (intraclass correlation coefficient (ICC)=0.78–0.87 and ICC=0.70–0.86, respectively, p=2.1x10–7 to 3.5x10–10 and p=7.8x10–6 to 1.3x10–9, respectively). These results suggest the algorithm performs similarly to human graders in MA and leakage segmentation and may be of significan...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Ehlers, J. P., Wang, K., Vasanji, A., Hu, M., Srivastava, S. K. Tags: Innovations Source Type: research

Fundus findings in a series of patients with extrapulmonary tuberculosis in Thailand
Conclusion Ocular lesions consistent with TB were not rare in a group of patients who were undergoing or had recently completed treatment for eTB. Fundus examination may provide diagnostic information that could influence a clinician’s beliefs when diagnosing eTB. Given the low costs and immediate results of eye examination, this diagnostic test should be considered in patients suspected for eTB, especially when other tests are negative. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Jirawison, C., Liu, Y., Surasit, K., Maningding, E., Kamphaengkham, S., Ausayakhun, S., Heiden, D., Margolis, T. P., Gonzales, J. A., Acharya, N. R., Keenan, J. D. Tags: Global issues Source Type: research

European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 3: Treatment principles and options * Supported by the EGS Foundation: Part 1: Foreword; Introduction; Glossary; Chapter 3 Treatment principles and options
Chapter 3 Treatment Principles and Options3.1 - General Principles of Glaucoma Treatment The purpose of this chapter is to give a summary overview and it is not meant to be an all-inclusive text To assess the likely Rate of Progression (RoP) is an important part of patient management and the measured rate is a very important factor that should determine target pressure and treatment intensity (See Ch. Introduction) [I.D]. Many studies have found that progression is usually linear1-4, but the goal of intensifying treatment is to decrease rate of progression. Please observe that perimetric printouts of progression using the ...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Tags: Open access Supplementary pages Source Type: research

Highlights from this issue
Cataracts induced by neodymium-yttrium-aluminum-garnet laser lysis of vitreous floaters (see page XXX) The authors highlight the formation of cataracts with posterior capsular compromise—after neodymium–yttrium-aluminum-garnet (Nd:YAG) laser vitreolysis for symptomatic vitreous floaters—a potentially serious and undesirable complication of the procedure. Vitrectomy with and without encircling band for pseudophakic retinal detachment: VIPER study report no. 2 â "main results (see page XXX) Additional scleral buckling is not superior to vitrectomy alone in pseudophacic retinal detachment. Suturel...
Source: British Journal of Ophthalmology - May 30, 2017 Category: Opthalmology Authors: Barton, K., Chodosh, J., Jonas, J. B. Tags: At a glance Source Type: research

European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 2: Classification and terminology * Supported by the EGS Foundation: Part 1: Foreword; Introduction; Glossary; Chapter 2 Classification and Terminology
2Classification and Terminology2.1- Primary Congenital Forms/Childhood Glaucomas Primary congenital glaucoma is a rare disease but has a major impact on the child’s development and quality of life over his/her whole life span. Early diagnosis and appropriate therapy can make a huge difference in the visual outcome and can prevent lifelong disability. Surgical treatment is always necessary1, 2 [I,C]. 2.1.1Primary congenital glaucoma (PCG): from birth to>2 years of life Neonatal or newborn onset (0-1 month) Infantile onset (>1 until 24 months) Late onset or late recognized (>2 years) Spontaneously non-progress...
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Tags: Open access Supplementary pages Source Type: research

Vision impairment and major eye diseases reduce vision-specific emotional well-being in a Chinese population
Aims To assess the relationship between vision impairment (VI) and major eye diseases, with vision-specific emotional well-being in a Chinese population. Methods In this population-based cross-sectional study, 3353 Chinese participants aged 40–80 years answered the emotional well-being scale of the Impact of Vision Impairment questionnaire, validated using Rasch analysis. Participants underwent visual acuity testing and collection of sociodemographic and medical data from standardised questionnaires. The relationships between presenting bilateral VI, presence of major eye diseases (cataract, undercorrected refr...
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Fenwick, E. K., Ong, P. G., Man, R. E. K., Sabanayagam, C., Cheng, C.-Y., Wong, T. Y., Lamoureux, E. L. Tags: Angle, Intraocular pressure, Lens and zonules, Optic nerve, Retina, Glaucoma, Optics and refraction, Epidemiology Original articles - Clinical science Source Type: research

Long-term complications of different porous orbital implants: a 21-year review
Conclusions Late exposures of porous orbital implants were noted during long-term follow-up. The causes of implant exposure may be associated with pegging procedures and evisceration. The implantation of dermis fat can be an effective procedure for the management of large-area implant exposure. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Lin, C.-W., Liao, S.-L. Tags: Original articles - Clinical science Source Type: research

Expression and clinical significance of connective tissue growth factor (CTGF) in Graves' ophthalmopathy
Aims To examine the expression of connective tissue growth factor (CTGF) in human cultured orbital fibroblasts from patients with Graves' ophthalmopathy (GO) and investigate whether a correlation exists between the presence of CTGF protein and clinical parameters of the disease. Methods The protein expression levels of CTGF were analysed by western blots in cultured orbital fibroblasts from 10 patients with GO and 7 age-matched normal controls. Associations between the protein expression of CTGF and the clinical factors of GO, including clinical demographics, thyroid function, clinical activity score (CAS) and ophthalmopa...
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Huang, Y.-M., Chang, P.-C., Wu, S.-B., Kau, H.-C., Tsai, C.-C., Liu, C. J.-L., Wei, Y.-H. Tags: Original articles - Clinical science Source Type: research

Progression of asymptomatic optic disc swelling to non-arteritic anterior ischaemic optic neuropathy
Conclusions Current treatment options for NAION once vision loss occurs are limited and may not alter the natural history of the disorder. Subjects with NAION may have disc swelling for 2–10 weeks prior to the occurrence of visual loss, and with the development of new therapeutic agents, treatment at the time of observed disc swelling could prevent vision loss from NAION. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Subramanian, P. S., Gordon, L. K., Bonelli, L., Arnold, A. C. Tags: Optic nerve, Neurology Original articles - Clinical science Source Type: research

Is prophylactic laser peripheral iridotomy for primary angle closure suspects a risk factor for cataract progression? The Chennai Eye Disease Incidence Study
Background To report the risk of cataract progression among primary angle closure suspects (PACS) 6 years after they underwent laser peripheral iridotomy (LPI). Methods In the Chennai Eye Disease Incidence Study, 6 years after their baseline evaluation, 4421 subjects were examined again. As part of a detailed evaluation cataract was graded using the Lens Opacities Classification System II; progression was defined as change of cataract by two or more grades or history of cataract surgery in the 6-year period. Only bilaterally phakic subjects with less than N2 or C2 or P2 cataract at baseline with no history of any for...
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Vijaya, L., Asokan, R., Panday, M., George, R. Tags: Editor's choice Original articles - Clinical science Source Type: research

Morphometric characterisation of pterygium associated with corneal stromal scarring using high-resolution anterior segment optical coherence tomography
Aims To investigate the role of high-resolution anterior segment optical coherence tomography (HR-ASOCT) in the assessment of pterygia. Methods Single centre cross-sectional study. Patients with primary pterygium and/or pingueculae were included. Clinical assessment included HR-ASOCT, colour photography, keratometry followed by histology. Associations were tested between HR-ASOCT features of the pterygium and the degree of corneal scarring and elastotic degeneration, astigmatism and best-corrected visual acuity. Results 29 eyes of 26 patients with pterygium and 6 patients with pinguecula were included. Apical anterior st...
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Gasser, T., Romano, V., Seifarth, C., Bechrakis, N. E., Kaye, S. B., Steger, B. Tags: Original articles - Clinical science Source Type: research

Panoramic view of human corneal endothelial cell layer observed by a prototype slit-scanning wide-field contact specular microscope
Conclusions A prototype slit-scanning wide-field contact specular microscope enabled us to record the endothelial layer from the surgical limbus to limbus of the cornea and compare specific areas among subjects, and showed that ECD in each region of the cornea decreases with ageing. Trial registration number UMIN000021264, Results. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Tanaka, H., Okumura, N., Koizumi, N., Sotozono, C., Sumii, Y., Kinoshita, S. Tags: Original articles - Clinical science Source Type: research

Comparison of corneal biomechanics after microincision lenticule extraction and small incision lenticule extraction
Objectives To evaluate and compare the change in corneal biomechanical properties after microincision lenticule extraction (MILE) and small incision lenticule extraction (SMILE). Methods In this prospective study, 60 eyes received MILE surgery with 2 mm opening incision, while 64 eyes received SMILE procedure with 5 mm opening incision. Corneal hysteresis (CH), corneal resistance factor (CRF) and 37 other biomechanical waveform parameters were quantitatively assessed using ocular response analyser (ORA) preoperatively and up to 6 months postoperatively. All changes were calculated as the difference between preoperati...
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Wu, Z., Wang, Y., Zhang, J., Chan, T. C. Y., Ng, A. L. K., Cheng, G. P. M., Jhanji, V. Tags: Original articles - Clinical science Source Type: research

Safety outcomes and long-term effectiveness of ex vivo autologous cultured limbal epithelial transplantation for limbal stem cell deficiency
Conclusions This study addresses important issues regarding possible risks associated with disarray of the ocular surface homeostasis following autologous CLET in patients with limbal stem cell deficiency, despite the fact that the majority of patients experienced a favourable long-term benefit. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Fasolo, A., Pedrotti, E., Passilongo, M., Marchini, G., Monterosso, C., Zampini, R., Bohm, E., Birattari, F., Franch, A., Barbaro, V., Bertolin, M., Breda, C., Di Iorio, E., Ferrari, B., Ferrari, S., Meneguzzi, M., Ponzin, D. Tags: Original articles - Clinical science Source Type: research

Non-traumatic corneal perforations: aetiology, treatment and outcomes
Conclusions Corneal perforations represent an important cause of ocular morbidity. The use of a cyanoacrylate patch is useful as an initial therapy in corneal perforations; however, procedures such as PK are often necessary to achieve anatomical success, especially in non-infectious aetiologies. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Loya-Garcia, D., Serna-Ojeda, J. C., Pedro-Aguilar, L., Jimenez-Corona, A., Olivo-Payne, A., Graue-Hernandez, E. O. Tags: Original articles - Clinical science Source Type: research

Characteristics and vitreoretinal management of retinal detachment in eyes with Boston keratoprosthesis
Conclusions The study showed that retinal detachment complicated by PVR, as demonstrated by the clinical and histological characteristics of this condition, is common in patients undergoing Boston keratoprosthesis. We also showed that 23-gauge vitrectomy can be effectively performed in patients with a permanent prosthesis. Visual acuity often remains poor, despite successful anatomical results. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Petrou, P., Banerjee, P. J., Wilkins, M. R., Singh, M., Eastlake, K., Limb, G. A., Charteris, D. G. Tags: Ophthalmologic surgical procedures, Retina, Vitreous Original articles - Clinical science Source Type: research

Retinal reattachment and ERG recovery after ophthalmic artery chemosurgery for advanced retinoblastoma in eyes with minimal baseline retinal function
Aim To report retinal function outcomes after ophthalmic artery chemosurgery (OAC) for advanced retinoblastoma (RB) in eyes with minimal pretreatment retinal function. Methods For 72 advanced RB eyes with baseline electroretinograms (ERGs) indistinguishable from noise (‘extinguished’) or flicker ERG amplitudes
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Abdelhakim, A. H., Francis, J. H., Marr, B. P., Gobin, Y. P., Abramson, D. H., Brodie, S. E. Tags: Original articles - Clinical science Source Type: research

Choroidal neovascularisation on optical coherence tomography angiography in punctate inner choroidopathy and multifocal choroiditis
Conclusion In patients with PIC and MCP complicated by CNV, OCTA successfully identified underlying CNV. Given the difficulty of differentiating inflammatory lesions from early CNV on OCT and FA, OCTA may provide a valuable method of monitoring patients with posterior uveitis highly correlated with development of CNV. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Levison, A. L., Baynes, K. M., Lowder, C. Y., Kaiser, P. K., Srivastava, S. K. Tags: Original articles - Clinical science Source Type: research

Optical coherence tomography angiography of myopic choroidal neovascularisation
Conclusions We describe the OCT-A features of myopic CNV secondary to pathological myopia and demonstrate its high sensitivity and specificity for neovascular detection. Qualitative evaluation of OCT-A characteristics may allow one to recognise different patterns, possibly corresponding to different degrees of neovascular activity. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Querques, L., Giuffre, C., Corvi, F., Zucchiatti, I., Carnevali, A., De Vitis, L. A., Querques, G., Bandello, F. Tags: Original articles - Clinical science Source Type: research

Repeatability of swept-source optical coherence tomography retinal and choroidal thickness measurements in neovascular age-related macular degeneration
Conclusions This study suggests that a change>23.2% of retinal thickness and 57.2 μm choroidal thickness in the central macular subfield is required to distinguish true clinical change from measurement variability when using the DRI OCT-1 device to manage patients with nAMD. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Hanumunthadu, D., Ilginis, T., Restori, M., Sagoo, M. S., Tufail, A., Balaggan, K. S., Patel, P. J. Tags: Original articles - Clinical science Source Type: research

Optical coherence tomography angiography of type 3 neovascularisation in age-related macular degeneration after antiangiogenic therapy
Conclusions The microvascular morphology of type 3 neovascularisation secondary to AMD was assessed at baseline and follow-up and showed significant regression in response to anti-VEGF therapy by OCTA. Quantitative OCTA analysis was also performed and confirmed remarkable regression in response to a single intravitreal anti-VEGF injection. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Phasukkijwatana, N., Tan, A. C. S., Chen, X., Freund, K. B., Sarraf, D. Tags: Original articles - Clinical science Source Type: research

The impact of typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy on vision-related quality of life in Asian patients
Conclusions Neovascular AMD, including both PCV and tAMD subtypes, has a detrimental impact on VRQoL in Asian subjects independent of level of vision impairment. Interventions to increase reading capacity, enhance mobility and independence and improve mental health outcomes for subjects with neovascular AMD further address the impact of the condition on VRQoL in addition to pharmacological therapies. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Fenwick, E. K., Cheung, C. M. G., Ong, P. G., Tan, G., Lee, S. Y., Yeo, I., Cheng, C. Y., Wong, T. Y., Lamoureux, E. L. Tags: Original articles - Clinical science Source Type: research

Preferred practice pattern in central serous chorioretinopathy
Conclusions While there are some common practice patterns for of CSC, there are still variations in regional and individual practice patterns indicating the need to establish more definitive practice guidelines. This survey data could be useful to plan a prospective study to address many unanswered questions. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Mehta, P. H., Meyerle, C., Sivaprasad, S., Boon, C., Chhablani, J. Tags: Original articles - Clinical science Source Type: research

En face choroidal vascular feature imaging in acute and chronic central serous chorioretinopathy using swept source optical coherence tomography
Conclusions En face imaging of SS-OCT is useful when combined with angiography in CSC for evaluating choroidal vessel dilatation at Haller's layer and to identify obscured upper layers. We identified different choroidal vessel dilatation patterns between acute and chronic CSC. These findings might be useful for pathophysiological understanding of CSC. (Source: British Journal of Ophthalmology)
Source: British Journal of Ophthalmology - April 18, 2017 Category: Opthalmology Authors: Lee, W. J., Lee, J. W., Park, S. H., Lee, B. R. Tags: Original articles - Clinical science Source Type: research