Author: Ophthalmology

Long-Term Trends in Glaucoma-Related Blindness in Olmsted County, Minnesota – Corrected Proof

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Objective: To determine the longitudinal trends in the probability of blindness due to open-angle glaucoma (OAG) in Olmsted County, Minnesota, from 1965 to 2009.Design: Retrospective, population-based cohort study.Participants: All residents of Olmsted County, Minnesota (aged ≥40 years) who were diagnosed with OAG between January 1, 1965, and December 31, 2000.Methods: All available medical records of every incident case of OAG were reviewed until December 31, 2009, to identify progression to blindness, defined as visual acuity ≤20/200 or visual field constriction to ≤20°. Kaplan–Meier analysis was used to estimate the cumulative probability of glaucoma-related blindness. Population incidence of blindness within 10 years of (Read more...)

Circularity Index as a Risk Factor for Progression of Geographic Atrophy – Corrected Proof

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Objective: To develop a parameter that can assess the relative rate of progression of geographic atrophy (GA) based on the hypothesis that noncircular configuration of the atrophic lesion may be a risk factor for enlargement.Design: Cohort study.Participants: Digitized color photographs of 593 eyes with GA from the Age-Related Eye Disease Study (AREDS).Methods: A novel parameter called the “Geographic Atrophy Circularity Index” (GACI) was developed on the basis of area and perimeter measurements to categorize the irregularity of the shape of GA. The GACI ranges from 0.0 to 1.0 and is categorized into 3 groups: 0.25 (very irregular), 0.25 to <0.75 (Read more...)

Risk Factors for Amblyopia in the Vision in Preschoolers Study – Corrected Proof

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Objective: To evaluate risk factors for unilateral amblyopia and for bilateral amblyopia in the Vision in Preschoolers (VIP) study.Design: Multicenter, cross-sectional study.Participants: Three- to 5-year-old Head Start preschoolers from 5 clinical centers, overrepresenting children with vision disorders.Methods: All children underwent comprehensive eye examinations, including threshold visual acuity (VA), cover testing, and cycloplegic retinoscopy, performed by VIP-certified optometrists and ophthalmologists who were experienced in providing care to children. Monocular threshold VA was tested using a single-surround HOTV letter protocol without correction, and retested with full cycloplegic correction when retest criteria were met. Unilateral amblyopia was defined as an interocular difference in (Read more...)

Defects of the Lamina Cribrosa in Eyes with Localized Retinal Nerve Fiber Layer Loss – Corrected Proof

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Objective: To determine whether focal abnormalities of the lamina cribrosa (LC) are present in glaucomatous eyes with localized retinal nerve fiber layer (RNFL) defects.Design: Cross-sectional, observational study.Participants: We analyzed 20 eyes of 14 subjects with localized RNFL defects detected by masked grading of stereophotographs and 40 eyes of 25 age-matched healthy subjects recruited from the Diagnostic Innovations in Glaucoma Study at the University of California, San Diego.Methods: All eyes had stereoscopic optic disc photography and in vivo LC imaging using enhanced depth imaging optical coherence tomography (EDI-OCT). Two masked graders identified focal LC defects defined by a standardized protocol using 48 (Read more...)

Intravitreal Aflibercept for Treatment-Resistant Neovascular Age-Related Macular Degeneration – Corrected Proof

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Objective: To assess the effectiveness of intravitreal aflibercept in patients with neovascular age-related macular degeneration (AMD) previously resistant to treatment with other anti–vascular endothelial growth factor agents.Design: Prospective, open-label, noncontrolled, registered clinical trial.Participants: Forty-nine patients with treatment-resistant neovascular AMD.Intervention: A dose of 2 mg intravitreal aflibercept was administered as 3 initial loading doses every 4 weeks (week 0, week 4, and week 8), followed by further injections every 8 weeks (weeks 16 and 24) across a 24-week period in total. All patients underwent a complete ophthalmic examination, including measurement of Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA), (Read more...)

Assessment of the Quality of Glaucoma Referral Letters Based on a Survey of Glaucoma Specialists and a Glaucoma Guideline – Corrected Proof

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Objective: To assess the quality of glaucoma referral letters and to report on the results of a survey of glaucoma specialists about referral letter content.Design: Cross-sectional study.Participants: A survey of 135 glaucoma specialists and audit of 200 consecutive referral letters to a tertiary glaucoma unit.Methods: An online questionnaire was sent to members of the Canadian and American Glaucoma Societies asking what they considered the most important data to be included in a glaucoma referral. Consecutive referral letters to a tertiary glaucoma unit were assessed for legibility and content on the basis of the survey results and information items in current (Read more...)

Prognostic Factor Analysis of Vitrectomy for Retinal Detachment Associated with Myopic Macular Holes – Corrected Proof

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Purpose: To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole (MH) and to analyze the prognostic and surgical factors predicting retinal reattachment and MH closure.Design: Retrospective case series.Participants: All patients who underwent vitrectomy for RD resulting from myopic MH between 2000 and 2009 at our center.Methods: Case records were reviewed at 6 months after surgery. Retinal reattachment and complete anatomic success, defined as retinal reattachment with MH closure, were assessed. Multivariate logistic regression models, including age, gender, duration of symptoms, spherical equivalent refraction (SE), internal limiting (Read more...)