Re: Zweifel et al.: Clinical and histopathologic findings in disseminated Mycobacterium chimera infection after cardiothoracic surgery (Ophthalmology. 2017;124:178-188)
The report by Zweifel et al1 is an important paper. The findings of such nontuberculous mycobacteria in lung granulomas of a patient with choroidal lesions so similar to those seen in active multifocal choroiditis (MFC) buttresses previous speculation that such agents are a cause of MFC, particularly in areas where histoplasmosis is not endemic.2 In fact, given the recognized unreliability of skin test evaluation and the ubiquitous environmental presence of nontuberculous mycobacteria, they could also be causative in histoplasmosis endemic areas. (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Robert Watzke Tags: Correspondence Source Type: research
Public Health Burden and Potential Interventions for Myopia
Myopia is the most common ocular abnormality in the world.1,2 Its growing prevalence has resulted in it reaching near ubiquitous status in many East Asian communities, affecting 80% to 90% of young adults in many communities.3 –5 Approximately one third of adult Americans and Europeans are myopic.6,7 A limitation of both of these estimates is that they used noncycloplegic refractions, which may have overestimated myopia in younger patients because of accommodation.6,7 The estimated prevalence of myopia (≤−0.75 diopt ers [D]) among Europeans aged 50 to 54 years is 33.6%, with 2.6% of those in this age group being high...
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Bobeck S. Modjtahedi, Frederick L. Ferris, David G. Hunter, Donald S. Fong Tags: Editorial Source Type: research
Reply
We would like to thank Dr Watzke for his interest in our article.1 (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Sandrine A. Zweifel, Peter M. Keller, Barbara Hasse, Daniel Barthelmes, Christian B öni Tags: Correspondence Source Type: research
Re: Assel et al.: Genetic polymorphisms of CFH and ARMS2 do not predict response to antioxidants and zinc in patients with age-related macular degeneration (Ophthalmology. 2018;125:391-397)
We requested that the National Institutes of Health Agency of Intramural Research Integrity investigate the use of the National Eye Institute's position of authority to advance its commercial interest in the Age-Related Eye Disease Study (AREDS) formulation. A statistical review was commissioned and is reported, in part, in the publication by Assel et al.1 As part of the review process genotypes from 535 AREDS cases that were not analyzed in the publications that first highlighted potential genotype-specific harm and previously unavailable were provided. (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Brent Zanke Tags: Correspondence Source Type: research
Reply
In response to Dr Zanke's letter, we would first note that he raises no objection to the substantive content of our paper. Zanke's comments seem to us to be an effort in moving the goalposts: yes, we are right that genotyping does not predict whether supplements reduce the risk of age-related macular degeneration (AMD) in general, but apparently that is not the point; genotyping predicts response with respect to only 1 type of AMD progression. (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Andrew J. Vickers Tags: Correspondence Source Type: research
Re: Srinivasan et al.: Comparison of new visual disturbances after superior versus nasal/temporal laser peripheral iridotomy: a prospective randomized trial (Ophthalmology. 2018;125:345-351)
We applaud Srinivasan et al1 for their well-powered study examining dysphotopsia's post-laser peripheral iridotomy (LPI) in a South Indian population. Their findings do contrast other reported studies with more diverse ethnic groups.2,3 Their study was designed to ensure that the LPI was covered by the eyelid superiorly a nd not covered in the temporal/nasal region. However, they failed to comment on the location of the LPI relative to the eyelid after the procedure. In addition, the short follow-up period of 2 weeks, is likely too short to adequately differentiate between a temporary and long-term dysphotopsia. (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Graham W. Belovay, Vanessa Vera, Devesh K. Varma, Iqbal Ike K. Ahmed Tags: Correspondence Source Type: research
Von Hippel-Lindau Incidentally Diagnosed in Evaluation of Sporadic Aniridia
A 15-year-old girl with history of unilateral sporadic aniridia presented with decreased vision and eye pain in the left eye (Fig 1A). Fundus examination of right eye revealed a capillary hemangioma inferonasally with circumferential exudation consistent with Von Hippel-Lindau Syndrome (VHL) (Fig 1B). Examination of the left eye revealed complete chronic exudative retinal detachment and neovascular glaucoma presumed to be due to capillary hemangioma (Fig 1C). Genetic testing and a systemic work-up were performed. (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Ian C. Holmen, Zackery Oakey, Michael M. Altaweel Tags: Pictures & Perspectives Source Type: research
Reply
We thank Belovay et al for their comments on our paper regarding how iridotomy location affects the likelihood of post-laser peripheral iridotomy (LPI) symptoms.1 We also congratulate them on their prior randomized trial on the same topic,2 and welcome an open discussion regarding why their trial noted significantly more new post-LPI linear dysphotopsias with superiorly placed iridotomies as compared with nasal/temporal LPIs (P = 0.002), whereas our trial showed no such difference (P = 0.6). Neither study showed group differences with regard to overall rates of dysphotopsia or other types of dysphotopsia. (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Kavitha Srinivasan, Nazlee Zebardast, Rengaraj Venkatesh, Pradeep Y. Ramulu Tags: Correspondence Source Type: research
Subconjunctival Mascara Deposition
A 50-year-old woman presented with chronic foreign body sensation in both eyes. She admitted to more than 25 years of heavy mascara use on her lashes with inadequate removal. Eversion of the upper lids revealed multiple darkly pigmented subconjunctival concretions, some eroding through the conjunctival surface (Fig 1A). This was associated with a patchy follicular conjunctivitis and punctate corneal erosions. Histopathological examination of a conjunctival biopsy revealed a chronic inflammatory infiltrate with pigmented macrophages, in keeping with foreign body deposition (Fig 1B). (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Dana Robaei Tags: Pictures & Perspectives Source Type: research
Deep Lamellar Endothelial Keratoplasty for Epithelial Ingrowth
A 9-year-old child presented with left eye corneal opacity for 5 months followed by trauma with plastic stick. There was greyish white opacity (Fig 1A), which seemed to be a fluid collection with in the well-defined anterior and posterior wall (yellow arrow), confirmed with anterior segment OCT (Fig 1B). The diagnosis of posttraumatic intracorneal epithelial cyst was made. We performed deep lamellar endothelial keratoplasty. The patient showed well attached lenticule along with clear visual axis 2 months postoperatively (Fig 1C). (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Bhupesh Bagga, Sridhar Rao Tags: Pictures & Perspectives Source Type: research
Direct View of the Angle Structures in Bilateral Congenital Megalocornea
A 3-year-old boy presented to the pediatric ophthalmology department with a diagnosis of bilateral congenital megalocornea. On observation, he had extremely large corneal diameters with minimal sclera show (Fig 1A), and the appearance of large palpebral apertures. There was a corneal optical aberration when viewed from the side (left eye; Fig 1B) and when magnified, it is possible to view the angle structures (right eye; Fig 1C) without the aid of a gonioscopy lens. Apart from the corneas, all anterior segment structures appeared to be normal, with no evidence of glaucoma. (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Damien C.M. Yeo, Stephanie Figg, William Moore Tags: Pictures & Perspectives Source Type: research
Predicting Choroidal Melanoma Regression after Brachytherapy
After brachytherapy, some choroidal melanomas regress faster than others. Several studies suggest that these tumors are more likely to metastasize than those that regress slowly. Not all authors support this view, some reporting no correlation between tumor regression and monosomy 3, which is highly lethal.1 More research is needed to determine whether tumor regression rate after brachytherapy predicts metastasis. (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Bertil Damato Tags: Commentary Source Type: research
Leukemic Optic Nerve Infiltration Responds to Radiation and Blinatumomab
A 52-year-old man with a history of Philadelphia chromosome negative B-cell acute lymphoblastic leukemia in remission presented with decreased vision in the right eye (OD) and headache. His visual acuity was count fingers OD and 20/20 left eye (OS). Fundoscopic examination revealed bilateral optic disc edema (Fig 1A and B). He was diagnosed with leukemic infiltration of the optic nerves. Treatment consisted of urgent radiotherapy and Blinatumomab, an anti-CD19 antibody that redirects T cells to enhance lysis of tumor cells. (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Erol Verter, Alina Yang, Renelle P. Lim Tags: Pictures & Perspectives Source Type: research
Retinal Imaging of an Optic Tract Lesion: OCT Angiography of Structural and Functional Defects
A 44-year-old man presented with a 10-month history of right-sided vision loss. Humphrey visual fields showed a right, incomplete homonymous hemianopia (Fig 1A) secondary to a left optic tract metastasis from melanoma (Fig 1C). Homonymous macular ganglion cell complex loss and “bow-tie” retinal nerve fiber loss were demonstrated with OCT (Fig 1B). OCT-angiography showed dropout of capillaries in the retinal superficial vascular plexus centered on the optic discs in the areas of “bow-tie” atrophy (Fig 1D). (Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Authors: Jonathan A. Micieli, Nancy J. Newman, Val érie Biousse Tags: Pictures & Perspectives Source Type: research
Editorial Board
(Source: Ophthalmology)
Source: Ophthalmology - April 19, 2018 Category: Opthalmology Source Type: research
