In response to the letter by Chen et al, we disagree with many of their assumptions and statements. We respond point-by-point to their concerns. In our published study, endophthalmitis was defined by the presence of positive intraocular cultures in a…
Author: Ophthalmology
Ciliary Body Lymphangiogenesis
With interest we read the recent article by Khan et al investigating the ciliary body for the presence of peritumoral lymphatic vessels in uveal melanoma with and without extraocular extension. This study confirms previous findings by Birke et al on th…
Molecular Analysis of Uveal Melanoma
Onken et al report a prospective evaluation of a gene expression profiling (GEP)-based assay, designed around 15 genes, that assigns uveal melanoma (UM) to 2 prognostic subgroups: Classes 1 and 2, which respectively are associated with low and high ris…
August 2012 Cover Photo Is Not Coats’ Disease
We were interested to see the cover photo on the August 2012 edition of Ophthalmology showing a fluorescein angiogram with findings attributed to macular telangiectasia type 1 (Coats’ disease). The wide field fluorescein angiogram very nicely demonstra…
Author reply
We appreciate the interest of Heindl et al in our recent article in which we report the presence of ciliary body lymphatics in all melanoma eye cases studied. Our group was the first to identify lymphatics in the ciliary body of the normal human eye. T…
Risk of Lens Opacity in Patients with Diabetes Mellitus
I read the paper entitled “Risk factors for incident cortical, nuclear, posterior subcapsular, and mixed lens opacities: the Los Angeles Latino Eye Study” with interest. The same authors also reported a population-based, cross-sectional study targe…
期刊一览
Richoz 等人 (p. 1354) 的一项长期随访研究发现角膜胶原交联术 (CXL) 可以有效阻止 LASIK 或准分子激光角膜切削术 (PRK) 术后角膜扩张的进展. 这一方法改善了患者最佳矫正远视力 (CDVA) 及最大K值 (Km…
This Issue At A Glance
Long-term results from a study by Richoz et al (p. 1354) show that corneal collagen cross-linking (CXL) effectively halts the progression of ectasia that has occurred after LASIK or photorefractive keratectomy (PRK). The procedure improves the correcte…
Adenoid Cystic Carcinoma of the Lacrimal Gland: Rare … Lethal … Cured?
There are few more difficult conversations in ophthalmology than that between a surgeon and a patient with newly diagnosed adenoid cystic carcinoma of the lacrimal gland. The results of conventional treatment, most commonly orbital exenteration followe…
A Simple Vista en Este Número
Los resultados a largo plazo de un estudio realizado por Richoz y otros (p. 1354) muestran que el enlace cruzado de colágeno corneal (CXL) detiene efectivamente la progresión de la ectasia producida después de LASIK o de queratectomía fotorrefracti…
Contents
Author reply
We appreciate the comments of Cereda et al regarding our article, “Highly reflective foveal region in optical coherence tomography in eyes with vitreomacular traction or epiretinal membrane.”
Author reply
I thank Dr Wilkinson for his interest in my article. He questioned whether the location of retinal breaks developing with posterior vitreous detachment (PVD) after phacoemulsification in eyes with lattice degeneration were associated with the lattice d…
Gene Expression Profiling versus TNM Classification
We appreciate the opportunity to respond to the letter from Kivelä and Kujala regarding our recent article that prospectively evaluated a gene expression profile (GEP) prognostic test for uveal melanoma. One of us (J.W.H.) was a primary member of the …
Keratitis-Induced Endophthalmitis
We read with great interest the article by Henry et al, which describes infectious keratitis progressing to endophthalmitis. This report provided us with valuable information on endophthalmitis contiguously spreading from keratitis. The study was simpl…
Erratum
With apologies from the editorial office, the Correspondence entitled, “Gene Expression Profiling vs. TNM Classification,” which printed in the May 2013 issue (Ophthalmology 2013;120:1109) erroneously included a statement that the authors of the or…
Author reply
We thank Sherwin et al for highlighting the importance of nonrefractive error as a cause of blindness and visual impairment in older Africans and the possibility that reporting refractive error as the leading cause of correctible vision loss could resu…
Alpha-1 Adrenergic Agonists for the Prevention of Floppy Iris Syndrome
We commend Lorente et al on their recent study regarding the efficacy of intracameral phenylephrine (iPNL) for the prevention of intraoperative floppy iris syndrome (IFIS). This prophylactic measure is among the alternatives currently adopted to minimi…
Examining Absolute Risk of AMD in Relation to Cataract Surgery
Cataract surgery is a common procedure in older adults. It is becoming more common not only by virtue of increasing age of the population, but also because of trends in ophthalmic practice and higher prevalence and incidence of late age-related macular degeneration (AMD) in persons who have had cataract surgery as has previously been reported. In the study by Klein et al, the maximally adjusted odds ratio (OR) for incidence of late AMD after cataract surgery compared with eyes with ≥1 type of cataract was 1.96 (95% confidence interval, 1.28–3.02). Including the presence and severity of early AMD lesions in the model somewhat attenuated the overall OR; however, the effect of surgery remained significant (P<0.05). Knowledge of the approximate doubling of the odds of late AMD is of limited use when making recommendations or decisions in clinical practice because this does not place the increased odds in the context of the actual risk. In the current report, we have described the adjusted attributable risk (AR) estimate and number needed to harm (NNH) to provide a measure of absolute risk when evaluating the effect of cataract surgery on incidence of late AMD.
Accuracy of Matching Optic Discs with Visual Fields: The European Structure and Function Assessment Trial (ESAFAT) – Corrected Proof
Purpose: To determine the ability of ophthalmologists across Europe to match stereoscopic optic disc photographs to visual fields of varying severity.Design: Evaluation and comparison of 2 diagnostic tests.Participants: A total of 109 of 260 invited ophthalmologists in 11 European countries. These had participated in the previous European Optic Disc Assessment Trial (EODAT), a trial on glaucoma diagnostic accuracy based on optic discs only.Methods: Each participant matched stereo optic disc photographs of 40 healthy and 48 glaucomatous eyes to a visual field chosen from 4 options per disc. The 4 presented visual fields included the corresponding one and 3 other visual fields, varying in severity. The matching accuracy and any inaccuracy per disease severity were calculated. Classification accuracy (as glaucomatous or healthy) was compared with EODAT data. Duplicate slides allowed for the assessment of intraobserver agreement.Main Outcome Measures: Accuracy of matching optic discs with their corresponding visual field and of classifying them as healthy or glaucomatous; intraobserver agreement (κ).Results: The overall accuracy of ophthalmologists for correctly matching stereoscopic optic disc photographs to their visual fields was 58.7%. When incorrectly matched, the observers generally overestimated the visual field severity (P < 0.001), notably in eyes with early glaucoma. The intraobserver agreement was, on average, moderate (0.52).Conclusions: European ophthalmologists correctly matched stereoscopic optic disc photographs to their corresponding visual field in only approximately 59% of cases. In most mismatches, the clinicians overestimated the visual field damage.Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.