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Highlights from this issue
Keith Barton/James Chodosh/Jost B Jonas/Editors in chief
doi : 10.1136/bjophthalmol-2021-318800
British Journal of Ophthalmology 2021;105:i-ii.
Notion of tolerating subretinal fluid in neovascular AMD: understanding the fine print before the injection pause
Ashish Sharma/ Nikulaa Parachuri/Nilesh Kumar/Francesco Bandello/Baruch D Kuppermann/Anat Loewenstein/Carl D Regillo/Usha Chakravarthy
doi : 10.1136/bjophthalmol-2020-317933
British Journal of Ophthalmology 2021;105:149-150.
Gene therapy for neovascular age-related macular degeneration: rationale, clinical trials and future directions
Thales Antonio Cabral de Guimaraes/Michalis Georgiou/James W B Bainbridge/Michel Michaelides
doi : 10.1136/bjophthalmol-2020-316195
British Journal of Ophthalmology 2021;105:151-157.
Age-related macular degeneration (AMD) is one of the leading causes of irreversible blindness in the developed world. Antivascular endothelial growth factor therapy has transformed the management and outcome of neovascular AMD (nAMD), although the need for repeated intravitreal injections—even lifelong—and the related complications, high drug costs, frequent clinic visits and repeated imaging have resulted in an enormous burden both to healthcare systems and patients. The application of gene therapy approaches for sustained delivery of a range of antiangiogenic proteins has the promise of helping to address these aforementioned challenges. A number of early phase clinical trials of gene therapy in nAMD have provided encouraging results, with many more ongoing or anticipated. There remain significant areas of controversy, including regarding the optimal treatment targets, routes of administration and potential safety concerns. In this review we aim to provide an update of the current status of gene therapy for nAMD and briefly discuss future prospects.
Artificial intelligence for anterior segment diseases: Emerging applications in ophthalmology
Darren Shu Jeng Ting/Valencia HX Foo/Lily Wei Yun Yang/Josh Tjunrong Sia/Marcus Ang/Haotian Lin/James Chodosh/Jodhbir S Mehta/Daniel Shu Wei Ting
doi : 10.1136/bjophthalmol-2019-315651
British Journal of Ophthalmology 2021;105:158-168.
With the advancement of computational power, refinement of learning algorithms and architectures, and availability of big data, artificial intelligence (AI) technology, particularly with machine learning and deep learning, is paving the way for ‘intelligent’ healthcare systems. AI-related research in ophthalmology previously focused on the screening and diagnosis of posterior segment diseases, particularly diabetic retinopathy, age-related macular degeneration and glaucoma. There is now emerging evidence demonstrating the application of AI to the diagnosis and management of a variety of anterior segment conditions. In this review, we provide an overview of AI applications to the anterior segment addressing keratoconus, infectious keratitis, refractive surgery, corneal transplant, adult and paediatric cataracts, angle-closure glaucoma and iris tumour, and highlight important clinical considerations for adoption of AI technologies, potential integration with telemedicine and future directions.
Morphological change and recovery of corneal endothelial cells after rho-associated protein kinase inhibitor eye-drop (ripasudil 0.4%) instillation
Yuko Maruyama/Yoko Ikeda/Kazuhiko Mori/Kengo Yoshii/Morio Ueno/Haruna Yoshikawa/Chie Sotozono/Shigeru Kinoshita
doi : 10.1136/bjophthalmol-2019-315776
British Journal of Ophthalmology 2021;105:169-173.
To investigate the time-dependent change of corneal endothelial cell (CEC) morphology and density (CECD) in patients with glaucoma post instillation of rho-associated protein kinase inhibitor ripasudil (Rip) 0.4% eye drops.
Bilateral morphometric analysis of corneal sub-basal nerve plexus in patients undergoing unilateral cataract surgery: a preliminary in vivo confocal microscopy study
Giuseppe Giannaccare/Federico Bernabei/Marco Pellegrini/Fabio Guaraldi/Federica TurchiCarlo Torrazza/Carlotta Senni/Riccardo Scotto/Daniele Sindaco/Luca Di Cello/Piera Versura/Vincenzo Scorcia/Carlo E Traverso/Aldo Vagge
doi : 10.1136/bjophthalmol-2019-315449
British Journal of Ophthalmology 2021;105:174-179.
To evaluate bilateral morphometric changes of corneal sub-basal nerve plexus (CSNP) occurring after unilateral cataract surgery by in vivo confocal microscopy (IVCM) images analysed with automated software.
Allogenic simple limbal epithelial transplantation (alloSLET) from cadaveric donor eyes in patients with persistent corneal epithelial defects
Jana Catharina Riedl/Aytan Musayeva/Joanna Wasielica-Poslednik/Norbert Pfeiffer/Adrian Gericke
doi : 10.1136/bjophthalmol-2019-315176
British Journal of Ophthalmology 2021;105:180-185.
To describe the clinical outcome of allogenic simple limbal epithelial transplantation (alloSLET) utilising tissue from cadaveric donor eyes after failed re-epithelialisation of the corneal surface.
Effect of long-term rigid gas-permeable contact lens wear on keratoconus progression
Satoko Araki/Shizuka Koh/Daijiro Kabata/Ryota Inoue/Daichi Morii/Naoyuki Maeda/Ayumi Shintani/Vishal Jhanji/Kohji Nishida
doi : 10.1136/bjophthalmol-2020-315942
British Journal of Ophthalmology 2021;105:186-190.
To investigate the chronological corneal changes associated with long-term rigid gas-permeable contact lens (RGP-CL) wear in patients with keratoconus (KC).
Puberty could regulate the effects of outdoor time on refractive development in Chinese children and adolescents
Jingjing Wang/Tianyu Cheng/Bo Zhang/Shuyu Xiong/Huijuan Zhao/Qiangqiang Li/Xiangui He
doi : 10.1136/bjophthalmol-2019-315636
British Journal of Ophthalmology 2021;105:191-197.
To explore the impact of puberty on refractive development and its interaction with outdoor time in children and adolescents.
Eye trauma in falls presenting to the emergency department from 2006 through 2015
Bushra Usmani/Asad Latif/Mustafa Iftikhar/Yasir J Sepah/Channing Parker/Justin A Fliss/Kunal K Dansingani/Syed Mahmood Ali Shah
doi : 10.1136/bjophthalmol-2019-314669
British Journal of Ophthalmology 2021;105:198-204.
To characterise the epidemiology of eye trauma in the event of falls presenting to the emergency departments (ED) in the USA.
Intraocular pressure changes following topical ocular hypotensive medications washout
Henrietta Ho/Arij Daas/ Jason Ho/Pouya Alaghband/Elizabeth Angela Galvis/Alba de Antonio Ramirez/Piergiacomo Grassi/Rongxuan Lim/Kin Sheng Lim
doi : 10.1136/bjophthalmol-2019-315778
British Journal of Ophthalmology 2021;105:205-209.
To review the changes in intraocular pressure (IOP) following topical hypotensive medications washout in patients with primary open angle glaucoma (POAG), ocular hypertension (OHT) and uveitic glaucoma (UG)/OHT.
Ocular toxoplasmosis: phenotype differences between toxoplasma IgM positive and IgM negative patients in a large cohort
Sofia Ajamil-Rodanes/Joshua Luis/Rabia Bourkiza/Benedict Girling/Angela Rees/Catherine Cosgrove/Carlos Pavesio/Mark Westcott
doi : 10.1136/bjophthalmol-2019-315522
British Journal of Ophthalmology 2021;105:210-215.
To investigate the differences in demographics and clinical characteristics of patients diagnosed with ocular toxoplasmosis according to their IgM status.
Visual acuity outcomes and anti-VEGF therapy intensity in diabetic macular oedema: a real-world analysis of 28 658 patient eyes
Thomas A Ciulla/John S Pollack/David F Williams
doi : 10.1136/bjophthalmol-2020-315933
British Journal of Ophthalmology 2021;105:216-221.
To assess visual acuity (VA) outcomes and antivascular endothelial growth factor (anti-VEGF) treatment intensity in diabetic macular oedema (DMO).
OCT-A characterisation of recurrent type 3 macular neovascularisation
Riccardo Sacconi/Marco Battista/Enrico Borrelli/Alexandra Miere/Eleonora Corbelli/Vittorio Capuano/Lea Querques/Eric H Souied/Francesco Bandello/Giuseppe Querques
doi : 10.1136/bjophthalmol-2020-316054
British Journal of Ophthalmology 2021;105:222-226.
To investigate optical coherence tomography angiography (OCT-A) findings in recurrent type 3 macular neovascularisation (MNV).
Visual outcomes after surgery for primary rhegmatogenous retinal detachment in era of microincision vitrectomy: Japan-Retinal Detachment Registry Report IV
Takayuki Baba/Ryo Kawasaki/Keita Yamakiri/Takashi Koto/Koichi Nishitsuka/Shuichi Yamamoto/Taiji Sakamoto
doi : 10.1136/bjophthalmol-2020-315945
British Journal of Ophthalmology 2021;105:227-232.
To determine the preoperative ocular factors and surgical methods that led to best-corrected visual acuity (BCVA) after pars plana vitrectomy (PPV) or scleral buckling (SB) for rhegmatogenous retinal detachment (RRD).
Optical coherence tomography angiography of flat irregular pigment epithelial detachments in central serous chorioretinopathy
Tingting Liu/Wei Lin/Shuping Zhou/ Xiangjuan Meng
doi : 10.1136/bjophthalmol-2019-315318
British Journal of Ophthalmology 2021;105:233-238.
To identify and analyse the character and relationship between flat irregular pigment epithelial detachment feature (FIPED), choroidal thickness and choroidal neovascularisation (CNV) network seen on optical coherence tomography angiography (OCTA) in eyes with central serous chorioretinopathy (CSCR) in Chinese patients.
Prognostic value of intermediate age-related macular degeneration phenotypes for geographic atrophy progression
Sarah Thiele/Jennifer Nadal/Maximilian Pfau/ Marlene Sa?mannshausen/Monika Fleckenstein/Frank G Holz/Matthias Schmid/Steffen Schmitz-Valckenberg
doi : 10.1136/bjophthalmol-2020-316004
British Journal of Ophthalmology 2021;105:239-245.
To characterise early stages of geographic atrophy (GA) development in age-related macular degeneration (AMD) and to determine the prognostic value of structural precursor lesions in eyes with intermediate (i) AMD on the subsequent GA progression.
Progression of retinopathy and incidence of cardiovascular disease: findings from the Chronic Renal Insufficiency Cohort Study
Juan E Grunwald/Maxwell Pistilli/Gui-Shuang Ying/Maureen G Maguire/Ebenezer Daniel/Revell Whittock-Martin/Candace Parker-Ostroff/Douglas Jacoby/Alan S Go/Raymond R Townsend/Crystal Ann Gadegbeku/ James P Lash/Jeffrey Craig Fink/Mahboob Rahman/Harold Feldman/ John W Kusek/Dawei Xie
doi : 10.1136/bjophthalmol-2019-315333
British Journal of Ophthalmology 2021;105:246-252.
Chronic kidney disease (CKD) patients often develop cardiovascular disease (CVD) and retinopathy. The purpose of this study was to assess the association between progression of retinopathy and concurrent incidence of CVD events in participants with CKD.
Long-term outcomes of treat-and-extend ranibizumab with and without navigated laser for diabetic macular oedema: TREX-DME 3-year results
John F. Payne/Charles C. Wykoff/W. Lloyd Clark/Beau B. Bruce/David S. Boyer/David M. Brown
doi : 10.1136/bjophthalmol-2020-316176
British Journal of Ophthalmology 2021;105:253-257.
To evaluate the long-term effects of treat-and-extend dosing of ranibizumab with and without navigated focal laser for diabetic macular oedema (DME).
Retinal light sensitivity as outcome measure in recessive Stargardt disease
Maximilian Pfau/Frank G. Holz/Philipp L. Müller
doi : 10.1136/bjophthalmol-2020-316201
British Journal of Ophthalmology 2021;105:258-264.
To evaluate the applicability of mesopic light sensitivity measurements obtained by fundus-controlled perimetry (FCP, also termed ‘microperimetry’) as clinical trial endpoint in Stargardt disease (STGD1).
Diagnostic accuracy of diabetic retinopathy grading by an artificial intelligence-enabled algorithm compared with a human standard for wide-field true-colour confocal scanning and standard digital retinal images
Abraham Olvera-Barrios/Tjebo FC Heeren/Konstantinos Balaskas/Ryan Chambers/Louis Bolter/Catherine Egan/Adnan Tufail/John Anderson
doi : 10.1136/bjophthalmol-2019-315394
British Journal of Ophthalmology 2021;105:265-270.
Photographic diabetic retinopathy screening requires labour-intensive grading of retinal images by humans. Automated retinal image analysis software (ARIAS) could provide an alternative to human grading. We compare the performance of an ARIAS using true-colour, wide-field confocal scanning images and standard fundus images in the English National Diabetic Eye Screening Programme (NDESP) against human grading.
Long-term natural history of visual acuity in eyes with choroideremia: a systematic review and meta-analysis of data from 1004 individual eyes
Liangbo L Shen/Aneesha Ahluwalia/Mengyuan Sun/Benjamin K Young/Holly K Grossetta Nardini/Lucian V Del Priore
doi : 10.1136/bjophthalmol-2020-316028
British Journal of Ophthalmology 2021;105:271-278.
Best-corrected visual acuity (BCVA) is the most common primary endpoint in treatment trials for choroideremia (CHM) but the long-term natural history of BCVA is unclear.
Prognostic factors for relapse and survival among patients with ocular adnexal lymphoma: validation of the eighth edition of the American Joint Committee on Cancer (AJCC) TNM classification
Miyoung Kwon/Ji Sung Lee/Chunghyun Lee/Dok Hyun Yoon/Ho-Seok Sa
doi : 10.1136/bjophthalmol-2020-315875
British Journal of Ophthalmology 2021;105:279-284.
Background/Aims To validate the prognostic performance of the American Joint Committee on Cancer (AJCC) eighth edition classification for ocular adnexal lymphoma (OAL).
In vivo confocal microscopy features and clinicohistological correlation of limbal nerve corpuscles
Mouhamed Ali Al-Aqaba/Fady S Anis/Imran Mohammed/Anjali Dias Samarawickrama Yapa/Winfried M Amoaku/Harminder Singh Singh Dua
doi : 10.1136/bjophthalmol-2018-313199
British Journal of Ophthalmology 2021;105:285-289.
To describe the in vivo confocal microscopy (IVCM) features of human limbal nerve corpuscles (LNCs) and correlate these with the histological features.
Characterisation of human orbital fibroblasts cultivated from intraconal, nasal and central adipose tissues
Jin A Kim/Donghyuck Ahn/Bo-Yeon Kim/Yeon Jeong Choi/Hyun Jung Shin/Sun Young Jang
doi : 10.1136/bjophthalmol-2018-313699
British Journal of Ophthalmology 2021;105:290-296.
To investigate the characteristics of human orbital fibroblasts (OFs) cultivated from intraconal, nasal and central adipose tissues.
Correction: Laser in glaucoma and ocular hypertension (LiGHT) Trial. A multicentre, randomised controlled trial: design and methodology
doi : 10.1136/bjophthalmol-2017-310877corr1
British Journal of Ophthalmology 2021;105:e1.
