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• W4385534822 abstract "Yuan et al (p. 786) evaluated the efficacy of laser peripheral iridotomy (LPI) prophylaxis for patients with primary angle-closure (PAC) suspect in a randomized controlled trial of 889 Chinese patients. Analysis of 33 LPI-treated eyes and 105 control eyes found acute angle closure in 1 LPI-treated eye and 5 control eyes and PAC in 2 LPI-treated eyes and 4 control eyes. Eyes treated with LPI showed a 69% reduced risk of PAC occurrence, with low incidence even at 14 years of follow up. Higher intraocular pressure, shallower limbal anterior chamber depth and greater central anterior chamber depth were significantly associated with PAC occurrence in LPI-treated or control eyes, with lower intraocular pressure elevation after darkroom prone provocative test being an additional risk factor in treated eyes. The study concludes that LPI reduces long-term risks of PAC by two-thirds, although overall incidence was quite low. The authors suggest that prophylactic LPI should be prescribed primarily for the high-risk population and recommend better prediction models to guide such prophylactic intervention. In this retrospective, observational, cohort study of adults from the IRIS® (Intelligent Research in Sight) Registry, MacCumber et al (p. 795) evaluated factors associated with anti-VEGF injection interval extension in patients with neovascular age-related macular degeneration switched to brolucizumab. Analysis of 2015 eyes from 1890 patients found that 1186 eyes (58.9%) were extenders who showed stable or improved vision with an extension in injection interval of at least 2 weeks at 12 months. A shorter pre-switch interval was significantly and positively associated with interval extension with brolucizumab therapy, and eyes with an index visual acuity of 40–65 letters were significantly less likely to be extenders than eyes in the higher index visual acuity categories. The authors conclude that a shorter pre-switch injection interval was the largest driver of successful interval extension with brolucizumab in treatment-experienced patients and suggest brolucizumab as a valuable treatment option for patients who need frequent injections. Bagger et al (p. 822) retrospectively assessed how copy number alterations of chromosomes 3 and 8q at the time of diagnosis influenced the incidence of local recurrence (LR) from uveal melanoma and disease-specific mortality among patients with LR. Analysis of 239 patients with primary uveal melanoma found that LR occurred in 42 patients (16%). Overall incidence of LR was not affected by the status of chromosomes 3 and/or 8q in the primary tumor. However, disease-specific mortality was significantly lower in the group without aberrations in chromosomes 3 and 8q, even after an LR. Local recurrence was identified as an independent risk factor for increased disease-specific mortality. The authors conclude that genetic status did not affect the incidence of LR in uveal melanoma, and LR development was associated with an enhanced risk of metastatic death, but only among patients with an abnormal chromosome 3 and 8q status. Marshall et al (p. 830) used a longitudinal cohort of glaucoma suspect and early manifest cases to prospectively assess whether a glaucoma polygenic risk score (PRS) was associated with the commencement or escalation of intraocular pressure-lowering therapy. A glaucoma PRS was calculated on 1107 participants. A higher glaucoma PRS was found to be associated with a greater risk of commencing intraocular pressure-lowering therapy among untreated glaucoma suspects and a higher risk of treatment escalation amongst treated suspect and manifest glaucoma cases. Compared to the lowest PRS quintile, untreated glaucoma suspects in the highest PRS quintile were 3.3 times more likely to be commenced on therapy by 5 years. Participants in the top quintile who were on treatment at enrollment were 1.8-fold more likely to require an escalation of therapy than the bottom quintile. The authors suggest that PRS could help with risk-based stratification and triage of glaucoma suspects. deCampos-Stairiker et al (p. 837) determined whether an artificial intelligence (AI) algorithm for evaluating retinopathy of prematurity (ROP) severity in babies can be used to assess changes in disease epidemiology over a 5-year period. Analysis of 3093 babies in a telemedicine program in South India found that among birthweight- and gestational-age matched babies, the proportion of babies with type 2 or worse and treatment-requiring-ROP decreased from 60.9% to 17.1% from August 2015 to October 2017 and 16.8% to 5.1%, from March 2019 to December 2020. The median vascular severity score in the population decreased from 2.9 to 2.4. The authors conclude that the relative risk of ROP declined significantly in South India, possibly due to improvements in primary prevention of ROP. The authors suggest that AI-based vascular severity scores may be useful for monitoring such epidemiological changes." @default.
• W4385534822 created "2023-08-04" @default.
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• W4385534822 date "2023-08-01" @default.
• W4385534822 modified "2023-09-24" @default.
• W4385534822 title "This Issue at a Glance" @default.
• W4385534822 doi "https://doi.org/10.1016/j.ophtha.2023.06.013" @default.
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