Category: Peer-reviewed

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…

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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.”

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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…

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We thank Dr Kawada for his insightful comments. It is not uncommon to find differences in the association between risk factors and (1) prevalent disease and (2) incident disease. These associations need to be interpreted differently. Risk factor associ…

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…

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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…

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.

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We are grateful to Dr Sangtam for the interest in our article, and for raising 2 interesting issues for further discussion. Based on previously available data, we find it hard to draw a simple conclusion that advanced and medically uncontrolled chron…