January 2019

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News in brief


Computer game playing among factors associated with myopia

A study in the British Journal of Ophthalmology concluded that exposure to video game playing was among the factors significantly associated with myopia. To understand early life factors associated with the increasingly prevalent condition, researchers examined a subset of the longitudinal British Twins Early Development Study recruited at birth between 1994 and 1996. Subjective refraction was obtained from the twins’ optometrists to identify myopia, which was defined as mean spherical equivalent <−0.75 D. A life course epidemiology approach was used to appropriately weigh candidate myopia risk factors during critical periods of eye growth. Factors significantly associated with myopia included level of maternal education, fertility treatment, summer birth, and hours spent playing computer games. Consistent associations were found with socioeconomic status, educational attainment, reading enjoyment and cognitive variables, particularly verbal cognition, at multiple points over the course of life.

Reference

Williams KM, et al. Early life factors for myopia in the British Twins Early Development Study. Br J Ophthalmol. 2018. Epub ahead of print.

Equal vitrectomy results found with straight or angled incisions

A study in Clinical Ophthalmology that compared straight and angled incisions in 27-gauge microincision vitrectomy in patients with epiretinal membrane (ERM) found equivalent results. The researchers retrospectively evaluated 73 eyes of 68 patients with ERM who underwent straight (35 eyes) or angled incision (38 eyes) for 27-gauge microincision vitrectomy. They found no statistically significant difference between the two groups in postop logarithm of minimum angle of resolution best corrected visual acuity. The intraocular pressure and rate of hypotony 1 day postop did not differ between the straight and angled incision groups, and surgical wound closing occurred by postop day 10 in both groups. “A straight incision is as safe and useful in ERM vitrectomy as an angled one,” the authors wrote.

Reference

Yomoda R, et al. Comparative study of straight vs angled incision in 27-gauge vitrectomy for epiretinal membrane. Clin Ophthalmol. 2018;12:2409–2414.

Higher incidence of dry eye found

The annual incidence of dry eye (DE), symptoms, and signs identified in a study published in the journal Cornea was higher than previously found in similar studies. An 11-year follow up on the Salnés Eye Study (SES), which was a cross-sectional population-based study of 654 subjects conducted from 2005 to 2006, found a DE rate of 2.3 per 100 person-years. DE was defined as the simultaneous presence of symptoms and at least one sign. A Schirmer test score <5 mm, tear film breakup time <10 seconds, rose bengal staining >3, and fluorescein staining >1 were considered indicative of signs. The 11-year incidence of DE was 25.4% and that of symptoms was 31.6% The incidence of DE was significantly associated with age. After adjusting for age, secondary or university studies were protective factors for DE; taking anxiolytics or antidepressants and angiotensin-converting enzyme inhibitors increased the risk of symptoms; a history of hypertension, chronic obstructive pulmonary disease, or autoimmune diseases increased the risk of signs. “This study suggests that some factors may increase the risk of symptoms, whereas other factors may increase the risk of signs,” the authors wrote.

Reference

Millán A, et al. Incidence and risk factors of dry eye in a Spanish adult population: 11-year follow-up from the Salnés Eye Study. Cornea. 2018;37:1527–1534.

No protective glaucoma benefit from oral memantine

Oral memantine was found to provide no neuroprotective benefit in open angle glaucoma (OAG) patients at risk for progression, according to a study in the journal Ophthalmology. Two randomized, double-masked, placebo-controlled, parallel-group, multicenter, 48-month studies were identically designed and initiated 1 year apart. The 2,298 patients with bilateral OAG, glaucomatous optic disc damage and visual field loss in one eye, glaucomatous optic disc damage and/or visual field loss in the contralateral eye had topically treated or untreated intraocular pressure of 21 mm Hg or less and were at risk of glaucomatous progression. They were randomized to receive memantine 20 mg, memantine 10 mg, or placebo tablets daily. Compared with placebo, daily treatment with memantine 10 mg or 20 mg for 48 months did not delay glaucomatous progression significantly in the individual studies and pooled analyses. The pooled risk reduction ratio assessed by standard automated perimetry was −0.13 (−0.40, 0.09) and −0.17 (−0.46, 0.07) for memantine 10 mg and 20 mg, respectively. Results were similar per frequency doubling technology and stereoscopic optic disc photographs. “With technologies available when the studies were conducted, daily treatment with memantine over 48 months was not shown to prevent glaucomatous progression in this patient population,” the authors wrote.

Reference

Weinreb RN, et al. Oral memantine for the treatment of glaucoma: design and results of 2 randomized, placebo-controlled, phase 3 studies. Ophthalmology. 2018;125:1874–1885.

Post-DALK refraction takes 6 months to stabilize

A retrospective, comparative interventional case series published in the journal Cornea concluded that it took 6 months to stabilize subjective refraction after deep anterior lamellar keratoplasty (DALK) was performed in keratoconus-affected eyes. The researchers analyzed the data of 73 eyes in 69 patients with keratoconus who underwent DALK. Only patients with clear grafts who had all sutures removed for at least 12 months were enrolled. The corrected distance visual acuity (CDVA) and manifest refraction were measured several months after all sutures were removed. No significant changes in the CDVA were observed during the follow-up period. Spherical equivalent refraction measured at 1 month (−3.18 ± 3.41 D) and 3 months (−4.29 ± 4.26 D) after complete suture removal differed significantly from that measured at the last examination (−4.70 ± 3.75 D; P=0.001 and 0.03, respectively). This measurement stabilized from 6 months after complete suture removal onward. Refractive astigmatism and its vector components (J0 and J45) did not change over time after complete suture removal. Since refraction stabilized 6 months after complete DALK suture removal, the authors suggested postponing refractive surgery until then to manage post-DALK refractive errors.

Reference

Javadi MA, et al. Refractive stability after deep anterior lamellar keratoplasty for keratoconus. Cornea. 2018;37:1506–1510.

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