Isolated Racemose Angioma —A Rare Retinal Condition
This case report describes a 42-year-old man who presented with isolated racemose angioma. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 8, 2019 Category: Opthalmology Source Type: research

Benign Familial Fleck Retina
This case report describes a teenaged patient with benign fleck retina. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 8, 2019 Category: Opthalmology Source Type: research

Spiderlike Appearance of Persistent Pupillary Membrane
This case report describes a 22-year-old woman who presented with persistent pupillary membrane that had a spiderlike appearance. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 8, 2019 Category: Opthalmology Source Type: research

Excision of a Large Cutaneous Horn
This caser report describes a hornlike, rubbery lesion over the right eyebrow of an elderly patient. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 8, 2019 Category: Opthalmology Source Type: research

When Genetics Can Point Researchers and Clinicians in New Directions
Ophthalmologists and clinicians throughout all disciplines of medicine and surgery have been deluged in recent years by the exponential growth of molecular genetic association studies (both of candidate genes and genome-wide) for a growing number of disorders, especially complex genetic conditions that defy traditional mendelian inheritance. Ophthalmology has led the way with the first real successes in the use of genome-wide association studies (GWAS) to elucidate the pathways of risk for the development of age-related macular degeneration (AMD). The genes identified from these GWAS efforts have become the basis for a num...
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

An Expanded Test Panel for Assessment of Fringe Benefits From Cataract Surgery
Chellappa et al have studied sleep and sleep-associated physiology and the association of cataract surgery with implant lenses that produce not only better imaging, but also better transmission of the visible spectrum. The authors recorded paraclinical photoentrainment parameters, electroencephalography during sleep, and sensorimotor reaction times in patients with newly bilateral pseudophakia and implant lenses that block only ultraviolet (UV) or UV plus blue light and compared them with healthy controls. The study included 13 individuals with pseudophakia and 16 controls, all with a conventional sleep/wakefulness pattern...
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Imaging of Isolated Choroidal Infarction Following Injection of Facial Filler
This case study describes the localization of isolated choroidal emboli with optical coherence tomography in a patient who had received an injection of calcium hydroxyapatite. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Novel Genome-Wide Significant Gene Loci and Lesion Growth in Geographic Atrophy in Age-Related Macular Degeneration
This pooled analysis of data from 4 cohort studies assesses the contribution of common genetic variants to geographic atrophy lesion growth secondary to age-related macular degeneration in older adults. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Association of Intraocular Cataract Lens Replacement With Circadian Rhythms, Cognitive Function, and Sleep in Older Adults
This cross-sectional study assesses whether intraocular cataract lens replacement in older patients with previous cataract is associated with the beneficial light effects on the circadian system, cognition, and sleep regulation. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Medication Accuracy in Electronic Health Records for Microbial Keratitis
This cross-sectional study investigates the concordance of the names of medications for microbial keratitis in the structured, formal electronic health record medication list and the text of clinicians ’ progress notes. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Successes and Challenges of Retinal Implants for Profound Visual Loss
The past decade has seen a leap in the development of treatment strategies for patients with profound visual loss from diffuse retinal degenerations, who previously were without treatment options beyond low vision devices. Patients with advanced photoreceptor and outer retinal degenerations such as retinitis pigmentosa now have the hope for visual restoration with novel approaches including the possibility of optogenetic therapy, stem cell therapy, and retinal prosthesis devices. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

The Debate Surrounding the Pathogenesis of Myopia
In this issue of JAMA Ophthalmology, Bez and colleagues report 9.3-fold increased odds of having myopia among a group of adolescent male students from an ultra-Orthodox community exposed to intense near-work activities (those done at a short working distance) from a very young age compared with age-matched secular adolescent male students without this exposure. The magnitude of the reported association in this study is enormous. The authors had great insight to study unique cultural differences that may be associated with the increasing rates and pathogenesis of myopia. Eye care professionals and policy makers should not u...
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Accurately Assessing Visual Deficits in Children With Developmental Dyslexia
To the Editor The recent article by Raghuram et al makes numerous assumptions about the association between eye movements and reading. One important assumption is that the Developmental Eye Movement (DEM) test is a measure of eye movements. However, the original article describing this test does not appear to provide any empirical evidence that there is any association between saccadic eye movement and reading. It does not seem sufficient for Raghuram et al to dismiss this assumption with the statement, “Some have questioned whether DEM is a valid measure of saccadic eye movements.”(p1094) Ayton et al have show...
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Accurately Assessing Visual Deficits in Children With Developmental Dyslexia —Reply
In Reply We thank Elder and Gole for their thoughtful comments on our article. Citing Ayton et al, they contend that the Developmental Eye Movement (DEM) test is not a valid indicator of saccadic eye movements. The Ayton et al study, however, had its own limitations: (1) it included only typical readers (restricting variability and hence correlations); (2) it did not consider normative age-associated changes in eye movements; and (3) it used saccadic measures of gain, latency, and velocity, rather than typical measures associated with reading, such as fixations and regressions. A 2018 study by Moiroud et al in children wit...
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Type of Educational System and Prevalence and Severity of Myopia Among Male Adolescents in Israel
This cross-sectional study analyzes the association between studying in different educational systems and the prevalence and severity of myopia among Jewish male adolescents in Israel. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Safety and Performance of the Argus II Retinal Prosthesis
This multicenter case series follows-up 47 patients who received the Argus II retinal prosthesis for severe to profound outer retinal degeneration to assess visual function and adverse events in the first year after implantation. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Visual Function Outcomes After Anti-VEGF Therapy for Macular Edema Due to Vein Occlusion
This secondary analysis of a randomized clinical trial compares the effect of intravitreal aflibercept and bevacizumab on patient-reported visual function in patients with macular edema secondary to central retinal or hemiretinal vein occlusion. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Sudden-Onset Painless Blurry Vision
A man in his late 30s with a history of proliferative diabetic retinopathy and cataract extraction with intraocular lens placement in the capsular bag is experiencing painless blurry vision. What do you do next? (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Metastasis and Survival as Future American Joint Committee on Cancer Pathologic T Categories for Conjunctival Melanoma
Jain et al report on validation of the staging system for conjunctival melanoma in the eighth edition of American Joint Committee on Cancer (AJCC) Cancer Staging Manual. The authors should be commended for trying to combine retrospectively collected data from across such a wide geographic and practice types using a web-based registry from 10 centers and 9 countries. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Assessment of the AJCC Cancer Staging Manual for Conjunctival Melanoma
This case series assesses whether the eighth edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual can be used to accurately estimate mortality rates of conjunctival melanoma. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Evaluating Safety and Effectiveness of New Ophthalmic Digital Devices
This Special Communication from The Ophthalmic Digital Health Workshop discusses the challenges of balancing providing patients with the most current innovations in ophthalmic digital health and maintaining appropriate safety and efficacy screening. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Corneal Opacification
A woman in her late 60s presented with progressive, painless blurring of vision in both eyes. She had bilateral, gray-white, irregular, poorly circumscribed, linear and nummular central and peripheral corneal opacities. What would you do next? (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

A Translucent Cystic Iris Lesion
An adolescent presents with photophobia and an iris lesion. There is no history of recent trauma. What would you do next? (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Analysis of Anti-VEGF Injection Claims Data in US Medicare Part B Beneficiaries From 2012 to 2015
This cohort study analyzes trends in anti –vascular endothelial growth factor (anti-VEGF) injections for US Medicare Part B beneficiaries from 2012 to 2015. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Posterior Segment Mass in a Woman With a Subluxed Crystalline Lens
A 72-year-old woman presents with a choroidal mass, subluxed crystalline lens, and occasional floaters and flashes in the right eye. What would you do next? (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Choroidal Neovascularization in Age-Related Macular Degeneration After Intravitreal Aflibercept or Ranibizumab
This second analysis of data from 2 randomized clinical trials investigated the association of intravitreal aflibercept vs ranibizumab and baseline characteristics with fellow eye conversion in patients treated for neovascular age-related macular degeneration in 1 eye. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

August 2019 Issue Highlights
(Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

JAMA Ophthalmology
Mission Statement: To be the indispensable source of ophthalmic knowledge by promptly publishing innovative, clinically relevant research through consistent and authoritative peer review and, thereby, to be the first choice of authors for their important manuscripts. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - August 1, 2019 Category: Opthalmology Source Type: research

Basal Cell Carcinoma Masquerading as a Chalazion in a 27-Year-Old Woman
This case report describes a 27-year-old woman with telangiectasias along the margin with inspissated Meibomian glands without discrete lesions in whom histopathological evaluation results demonstrated basal cell carcinoma. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 11, 2019 Category: Opthalmology Source Type: research

Lacy Fibers Over the Anterior Lens Capsule
This case report describes a 32-year-old woman with long-standing diminution of vision in the right eye whose slitlamp examination results showed a crisscross arrangement of fibers over the anterior surface of the anterior lens capsule confined to the central 3-mm diameter circular area that appeared to be emanating from a circle of dotlike raised white deposits. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 11, 2019 Category: Opthalmology Source Type: research

Corneal Salzmann Nodular Degeneration
This case report describes a 74-year-old woman a hyperechoic superficial corneal thickening sparing the stromal layer with a clear-cut demarcation line, suggesting a diagnosis of Salzmann nodular degeneration. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 11, 2019 Category: Opthalmology Source Type: research

Eyes Speak Before the Child Talks
This case report describes a 5-month-old boy with heterochromia irides, a forelock of white hair, and dystopia canthorum, classic features of Waardenburg syndrome. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 11, 2019 Category: Opthalmology Source Type: research

Improving Same-Day Access in Ophthalmology
Timely health care access has assumed increasing importance to consumers and practitioners. We are all aware of individuals who want their care when and where it is convenient. We are thus witnessing an increase of walk-in clinics, urgent care centers, after-hours clinics, and free-standing emergency departments (EDs). In ophthalmology, the desire of patients to be seen at their convenience has been compounded by an aging population and increased demand for services because most ophthalmologists are busy and have minimal capacity to add patients to their practices. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Updated Methods for Assessing Risk of Progression to Late AMD
Because age-related macular degeneration (AMD) has been and remains a leading cause of bilateral blindness, the fellow eye of patients with unilateral neovascular AMD has been studied intensively during the past 50 years. These investigations have aimed to identify the characteristics of eyes and patients that affect the risk of second eye involvement, not only to inform patients of their prognosis but also to increase knowledge about the pathological processes that are involved in the development and progression of AMD. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Spontaneous Stalk Regression in Persistent Fetal Vasculature Syndrome
This article presents a case of a persistent fetal vasculature syndrome resulting in spontaneous stalk regression in a microphthalmic eye. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Cost and Visit Duration of Same-Day Access at an Academic Ophthalmology Department vs Emergency Department
This quality improvement analysis evaluates the costs and visit durations of same-day access in an ophthalmology department at an academic medical center vs emergency department care. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Conversion From Nonneovascular to Neovascular Age-Related Macular Degeneration in the HARBOR Study
This secondary analysis of a randomized clinical trial assesses the imaging, genetic, and demographic factors associated with conversion from nonneovascular to neovascular disease in patients with age-related macular degeneration who were undergoing treatment for late disease in the fellow eye. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Diffuse Uveal Melanocytic Proliferation With Primary Vitreoretinal Lymphoma
This case study describes a patient presenting with uveal melanocytic proliferation without systemic malignant disease. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Gaze-Provoked Exotropia in a Young Woman
A 25-year-old woman presents with a 6-month history of intermittent diplopia that occurs when she looks to the right. What would you do next? (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Errors in Results Section and Tables 2 and 3
This article was corrected online. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

The Role of Statins and Cholesterol in the Primary Prevention of Primary Open-Angle Glaucoma
Primary prevention remains the ultimate challenge and noblest goal for averting the debilitating consequences of chronic disease. In glaucoma, lowering of intraocular pressure remains the only known modifiable risk factor to prevent disease development. The identification of new avenues for intervention, prior to the establishment of disease, is of utmost importance given the anticipated rise in glaucoma prevalence worldwide, especially among high-risk populations. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Quality of Life After Endothelial Keratoplasty
In this issue of JAMA Ophthalmology, Ang et al describe a prespecified secondary outcome of the Descemet Endothelial Thickness Comparison Trial (DETECT), a study designed to compare visual acuity outcomes from ultrathin Descemet stripping endothelial keratoplasty (UT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK). The main and primary study outcome was that DMEK eyes saw 1.4 lines better than UT-DSAEK eyes at 12 months. Although visual acuity is the traditional functional measure of surgical success in ophthalmology, increasingly patient-reported outcomes, particularly those measuring vision-related quality o...
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Oral Tyrosine Kinase Inhibitors for Neovascular Age-Related Macular Degeneration
To the Editor We recently reported a phase I dose-escalation study of the oral tyrosine kinase inhibitor vorolanib (previously known as X-82 [Tyrogenex]), which was used as a treatment for neovascular age-related macular degeneration (AMD). We have since been made aware of a 2008 report detailing 2 cases of neovascular AMD treated with oral sorafenib, which deserves mention. Like vorolanib, sorafenib is a multikinase inhibitor that has been used to treat cancer. It has theoretical utility as a treatment for wet AMD because it downregulates the production of vascular endothelial growth factor and platelet-derived growth fac...
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Statistical Issues on Evaluating Association Between the Cilioretinal Artery and Age-Related Macular Degeneration
To the Editor I read with great interest the article by Snyder et al evaluating association between the cilioretinal artery and age-related macular degeneration (AMD). The article provided interesting results showing that the presence of cilioretinal artery is significantly associated with lower rate of both prevalence and incidence of choroidal neovascularization (CNV) but is not associated with central geographic atrophy. However, after reading the article, there were a few statistical questions for which clarification would be of value, as described here: (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Evolution of Ellipsoid Zone Abnormalities on Optical Coherence Tomography Associated With Niacin Maculopathy
This article presents a case of maculopathy associated with niacin administration and complicated by persistent ellipsoid zone disruptions. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Statistical Issues on Evaluating Association Between the Cilioretinal Artery and Age-Related Macular Degeneration —Reply
In Reply We thank Ying for his helpful comments requesting clarification on several details in the table values and statistical analyses presented in our study. Most of the discrepancies appeared to have arisen during the transcription and reformatting of our original submitted manuscript to the final article proof, which were overlooked by us during the author proofing process. While these errors do not alter the overall conclusion of the manuscript, we have submitted an erratum to clarify these details for future readers. We address each comment individually here: (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Effect of Unilateral Endothelial Keratoplasty on Vision-Related Quality-of-Life Outcomes
This secondary analysis of a randomized clinical trial compares vision-related quality of life in patients who underwent Descemet membrane endothelial keratoplasty or ultrathin Descemet stripping automated endothelial keratoplasty. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Association of Statin Use and High Serum Cholesterol Levels With Risk of Primary Open-Angle Glaucoma
This population-based cohort assesses the association between elevated cholesterol levels, statin use, and incident primary open-angle glaucoma among participants 40 years or older. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

Protocol V Confirms a Role for Focal Laser Photocoagulation or Observation for Eyes With Center-Involved DME and Good VA
This commentary discusses a study published in JAMA that compares the effects of initial management with aflibercept, laser photocoagulation, or observation on vision loss among adults with diabetic macular edema and good visual acuity at baseline. (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research

A Man With a Large Conjunctival Lesion
A 27-year-old man presented to the clinic for evaluation of a painless, red mass in his right eye present since birth. What would you do next? (Source: JAMA Ophthalmology)
Source: JAMA Ophthalmology - July 1, 2019 Category: Opthalmology Source Type: research