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In This Issue of JAMA Ophthalmology
February 2014


JAMA Ophthalmol. 2014;132(2):131. doi:10.1001/jamaophthalmol.2013.5923

The Age-Related Eye Disease Study 2 (AREDS2) assessed the value of substituting lutein/zeaxanthin in the AREDS formulation because of the demonstrated risk for lung cancer from beta carotene in smokers and former smokers and because lutein and zeaxanthin are important components in the retina. The AREDS2 Research Group writing team examined the effect of lutein/zeaxanthin supplementation on progression to the advanced stage of AMD. Among 4203 participants with bilateral large drusen or large drusen and late AMD in 1 eye, exploratory analyses suggested a greater effect of lutein/zeaxanthin vs beta carotene for the development of neovascular AMD. The findings suggest that lutein/zeaxanthin could be more appropriate than beta carotene in AREDS-type supplements, especially among current smokers, and are discussed in an accompanying editorial by Musch.

Related Editorial

Because little is known regarding eye care use among low-income persons with diabetes mellitus, especially African American individuals, MacLennan and colleagues investigated eye care use among patients with diabetes who were seen in a county hospital clinic that primarily serves high-risk, low-income, non-Hispanic African American patients. Patients with a history of retinopathy and macular edema or a current diagnosis indicating ophthalmic complications were excluded. In this retrospective cohort study with 2 years of follow-up among 867 patients with diabetes, visits to an eye clinic for any eye care examination or procedure were low. The findings suggest that additional education efforts to increase the perception of need among urban minority populations may be enhanced if focused on younger persons with diabetes.

Because there is a lack of trials evaluating the efficacy of prismatic treatments for hemianopia, Bowers and colleagues evaluated the efficacy of real relative to sham peripheral prism glasses for patients with complete homonymous hemianopia in a multicenter, randomized, double-masked crossover trial. Of the 61 participants (among 73 randomized) who completed the crossover, real peripheral prism glasses appeared to be more helpful for obstacle avoidance when walking than sham glasses. The next steps might include a clinical trial with outcome measures evaluating functional performance on real-world or simulated mobility tasks.