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• W4236616073 abstract "Maloney et al (p. 1007) conducted a retrospective cohort study to assess the risk of systemic serious adverse events (SAEs) in patients receiving anti-vascular endothelial growth factor (VEGF) pharmacotherapy for diabetic macular edema (DME) compared with controls treated with macular laser photocoagulation. They used a large United States insurance claims database to identify patients aged ≥18 years treated with anti-VEGF for DME between January 1, 2006, and December 31, 2015, along with control patients receiving macular laser or corticosteroid. In the 23 348 patients who met the inclusion criteria, there was no difference in the hazard of cerebrovascular disease, major bleeding, or myocardial infarction between patients receiving anti-VEGF pharmacotherapy and patients treated with macular laser photocoagulation for DME, but the patients treated with anti-VEGF had an increased rate of all-cause hospital admission. There were no differences in 180-day event rates for any of the primary systemic SAE outcomes. The authors suggest that intravitreal anti-VEGF pharmacotherapy has a relatively safe systemic risk profile. In a longitudinal, observational study, Lee et al (p. 958) examined the association between physical activity levels and the rate of visual field (VF) loss in glaucoma. Between July 2009 and June 2011, 141 older adult participants with suspect or manifest glaucoma were recruited at the Wilmer Eye Institute at Johns Hopkins Hospital and wore accelerometers for 1 week to define their level of physical activity. Slower VF loss was observed for patients demonstrating more average steps per day, more moderate-to-vigorous activity, and more non-sedentary activity, with an additional 5000 daily steps, extra 2.6 hours of non-sedentary physical activity, or an extra 120 minutes of moderate-to-vigorous physical activity decreasing the average rate of VF loss by approximately 10%. Older age, non-white race, glaucoma surgery, cataract surgery, and moderate baseline VF damage were associated with a faster rate of VF loss. The authors conclude that greater physical activity was associated with a statistically significant slowing of VF loss in patients with glaucoma. Boland et al (p. 928) used publicly available data to investigate the participation and performance of ophthalmology compared with other medical specialties in the Medicare Electronic Health Record Incentive Program, a federal incentive program for meaningful use (MU) of electronic health record (EHR) systems. They found that in the peak year of participation, 51.6% of ophthalmologists successfully attested to MU, compared with 37.1% of optometrists, 50.2% of dermatologists, 54.5% of otolaryngologists, and 64.4% of urologists. Ophthalmologists were more likely to remain in the program without dropping out than average eligible providers and showed the largest increase in the percent of attesting providers. Unlike other similar specialties, ophthalmology was able to increase its overall share of incentive payments in each year of the program. The authors conclude that ophthalmology as a specialty performed better than optometry and dermatology, but worse than otolaryngology and urology, in terms of the proportion of eligible professionals attesting to MU of EHRs. Ferdi et al (p. 935) conducted a systematic review and meta-analysis of 11 529 eyes to describe the natural history of keratoconus. They identified 3950 publication titles from the Medline, Embase, CENTRAL, and CINAHL databases, of which 41 publications that reported on the natural history of keratoconus were included in the systematic review and 23 were incorporated into the meta-analysis. Patients younger than 17 years and those with maximum keratometry (Kmax) greater than 55 diopters (D) at presentation were more likely to have more than 1.5 D of Kmax progression. In addition, Middle Eastern patients experienced greater progression. Patients were predicted to have 0.8 D less Kmax steepening over 12 months for every 10-year increase in age, as well as 1 D greater Kmax steepening for every 5 D of greater baseline Kmax. The researchers conclude that younger patients and those with steeper Kmax have a significantly greater risk of progression of keratoconus. Parisi et al (p. 1033) used an electrophysiologic approach to assess functional changes in retinal ganglion cells (RGCs) and in visual pathways in untreated patients with Leber’s hereditary optic neuropathy (LHON) carrying different pathogenic mitochondrial DNA (mtDNA) mutations. They compared pattern electroretinogram (PERG) and visual evoked potentials (VEP) between 42 eyes from 22 patients with LHON in the chronic phase of the disease and 25 control eyes from 25 healthy participants. At baseline, a significant reduction of PERG A and significant abnormal VEP responses were observed in all LHON eyes compared with controls. At 6 and 12 months of follow-up, the majority of eyes in the LHON group showed unmodified PERG and VEP values, and mean absolute values of these measures were not significantly different from baseline values. However, there were cases with an improvement or a worsening of PERG responses in each mutation-specific group. The authors conclude that the function of RGCs and visual pathways was not significantly modified during 12 months of follow-up in patients with chronic LHON and specific mitochondrial mutations." @default.
• W4236616073 created "2022-05-12" @default.
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• W4236616073 date "2019-07-01" @default.
• W4236616073 modified "2023-09-25" @default.
• W4236616073 title "This Issue at a Glance" @default.
• W4236616073 doi "https://doi.org/10.1016/j.ophtha.2019.05.014" @default.
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