December 2018


News in brief

Efficacy, safety of regional corticosteroid injections compared in POINT Trial

The PeriOcular vs. INTravitreal corticosteroids for treatment of uveitic macular edema (POINT) Trial sought to provide randomized, comparative analysis of the periocular injection route and intravitreal injection route as well as the intravitreal injection route versus intravitreal implant for treatment of this condition. Uveitic macular edema persisting after treatment with oral corticosteroids and other immunosuppressive drugs is typically treated with periocular or intravitreal triamcinolone acetonide injections, Thorne et al. wrote in Ophthalmology. Among intravitreal options, triamcinolone acetonide can be injected or a dexamethasone sustained-release implant could be inserted. Ultimately, intravitreal triamcinolone acetonide and the intravitreal dexamethasone implant were better at treating uveitic macular edema, the study authors concluded.


Thorne J, et al. Periocular triamcinolone vs. intravitreal triamcinolone vs. intravitreal dexamethasone implant for the treatment of uveitic macular edema: The PeriOcular vs. INTravitreal corticosteroids for uveitic macular edema (POINT) Trial. Ophthalmology. 2018. Epub ahead of print.

Single needle modification to Yamane technique

The flanged, double-needle intrascleral haptic fixation technique first described by Shin Yamane, MD, involves the use of two ab externo needles, used for docking the haptics of an IOL, the ends of which are then flanged with light cautery and tucked into the sclera. In a paper published in the Journal of Cataract and Refractive Surgery, Hwang et al. suggest a single-needle technique “to simplify and possibly improve the safety” of Yamane’s double-needle technique.


Hwang ES, et al. Flanged intrascleral intraocular lens fixation with a single needle. J Cataract Refract Surg. 2018. Epub ahead of print.

“Eye dropping”: A case of transconjunctival drug delivery

A case report in the journal Cornea describes bilateral toxic corneal and conjunctival epitheliopathy in an 18-year-old patient who had placed filter paper with LSD in his conjunctival fornices. The patient presented at the emergency room with pain and redness in both eyes that had lasted for the prior 24 hours. Upon examination, a bulbar and palpebral conjunctival abrasion was observed. The patient did not follow up within a week but reported that his symptoms had improved. “To the best of our knowledge, this is the first reported case of bilateral hemorrhagic conjunctival abrasion and corneal abrasion secondary to LSD,” Lo et al. wrote.


Lo D, et al. “Eye dropping” – A case report of transconjunctival lysergic acid diethylamide drug abuse. Cornea. 2018;37:1324–1325.

Chiropractic care could be impacting vision

Research published in the American Journal of Ophthalmology Case Reports details how chiropractor adjustments of the neck could have a negative impact on vision. A 59-year-old female patient developed a “tadpole”-shaped spot in her vision after getting a spinal adjustment, which was intended to help with her headaches. Her vision returned to normal within 2 weeks. According to the paper, this is the first report of preretinal hemorrhages after chiropractic care. A press release from the Kellogg Eye Center, University of Michigan, Ann Arbor, about the case notes that the association between the preretinal hemorrhages and chiropractic care immediately prior to the visual disturbance is temporal.


Paulus Y, Belill N. Preretinal hemorrhages following chiropractor neck manipulation. Am J Ophthalmol Case Reports. 2018;11:181–183.

Secondary IOL four-point scleral fixation technique with 8-0 polypropylene

John et al. describe a new four-point, 8-0 polypropylene suture scleral fixation technique for a secondary IOL without the use of a handshake technique in the Journal of Cataract and Refractive Surgery. The technique, according to the study authors, is attractive as some physicians are unsatisfied with the use of 10-0 polypropylene for sutures due to its potential to degrade and polytetrafluoroethylene being off-label for ocular use. The technique involves a posterior chamber IOL, four sclerotomy sites 2.5 mm from the limbus, and two scleral grooves between the sclerotomy sites. As described by the investigators, 8-0 polypropylene sutures are passed through the haptics before the IOL is inserted behind the iris, and the sutures are pulled ab interno. Suture knots are embedded in the scleral groove and sealed with fibrin glue. The researchers said they used this technique in nine cases with the IOL showing stability and no suture-related complications after an average of 10 months.


John T, et al. New use of 8-0 polypropylene suture for four-point scleral fixation of secondary intraocular lenses. J Cataract Refract Surg. 2018. Epub ahead of print.

Initial blurry vision may help development of normal visual processing in babies

According to a study by Vogelsang et al. funded by the National Eye Institute (NEI), the initial phase of blurry vision may be fundamental to the development of normal visual processing in babies. The study was published online in the Proceedings of the National Academy of Sciences. According to an NEI press release, the researchers trained deep neural networks on a large database of facial images. Three different visual training scenarios were simulated by systematically blurring and increasing the resolution of the images. “In the first, they replicated an infant’s normal course of vision by training the network on blurry images, followed by high-resolution ones. In the second, the training order was reversed; high-resolution images were followed by low-resolution images. And lastly, the network was trained on only high-resolution images.” According to the study abstract, “The results show that commencing training with blurred images creates receptive fields that integrate information across larger image areas and leads to improved performance and better generalization across a range of resolutions.” In addition, the abstract states, “These findings offer an explanation for the observed face recognition impairments after late treatment of congenital blindness, suggest an adaptive function for the acuity trajectory in normal development, and provide a scheme for improving the performance of computational face recognition systems.”


Vogelsang L, et al. Potential downside of high initial visual acuity. Proc Natl Acad Sci USA. 2018;115:11333–11338.

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