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In This Issue of JAMA Ophthalmology
December 2015


JAMA Ophthalmol. 2015;133(12):1373. doi:10.1001/jamaophthalmol.2014.3752

Few studies have combined an objective measure of vision-related performance (VRP) and subjective measures of vision-related quality of life (VRQoL) with clinically related visual parameters in patients with glaucoma. Ekici and colleagues examine the relationships between clinical visual assessments and both a VRP and 2 self-reported VRQoL measurements in a large, prospective, cohort study setting. Among 161 patients enrolled, the strongest correlation identified was between the Spaeth-Richman Contrast Sensitivity score in the better eye and total Compressed Assessment of Ability Related to Vision (CAARV) score. The CAARV score also correlated with the Pelli-Robson score, visual field (VF) mean deviation, and visual acuity in the better eye. Recognizing that the results were limited by the patient population and apply only within the bounds of the tested cohort, the results suggest that contrast sensitivity tests and VF mean deviation were associated with both objective measures of the ability to act and subjective measurements of VRQoL.

Guggenheim and Williams examine whether myopia was associated with birth order in an earlier generation than studied previously and, if so, whether the association was attenuated after adjusting for education exposure, as predicted by the hypothesis that the education of children with later birth orders is less intense. In a cross-sectional study of 89 120 UK participants, restricting analysis to participants aged 40 to 69 years who had a vision assessment, self-reported white ethnicity, and no history of eye disorders, birth order was associated with myopia. After adjusting for education, the effect sizes were attenuated by approximately 25%. The data suggest that association between birth order and myopia is not due to a new environmental pressure in the last 30 to 40 years.

Continuing Medical Education

Wu and colleagues investigate the associations between intakes of carotenoids and age-related macular degeneration (AMD) with cohorts from the Nurses’ Health Study and the Health Professionals Follow-up Study in the United States. Among 63 443 women and 38 603 men, there were 1361 incident intermediate and 1118 advanced AMD cases (primarily neovascular AMD) with a visual acuity of 20/30 or worse by medical record review. Comparing extreme quintiles of predicted plasma lutein/zeaxanthin score, the authors found a risk reduction for advanced AMD of about 40% in both women and men. Predicted plasma carotenoid scores for other carotenoids were associated with a 25% to 35% lower risk of advanced AMD when comparing extreme quintiles. The results suggest higher intake of bioavailable lutein/zeaxanthin is associated with a long-term reduced risk of advanced AMD.

Author Audio Interview

Ladas and colleagues develop a graphical method for displaying intraocular lens (IOL) calculation formulas in 3 dimensions and describe a method that uses the most accurate and current information on IOL formulas, adjustments, and lens design to create one “super surface” and develop an IOL “super formula” on 100 eyes. The super formula localized to the correct portion of the super surface 100% of the time. Other individual formulas deviated from the optimal super formula IOL power values by more than 0.5 D 30% of the time in Hoffer Q, 16% in Holladay I, 22% in Holladay I with Koch adjustment, 48% in Haigis, and 24% in SRK/T. This method will broaden the conceptual understanding of IOL calculations, improve clinical outcomes for patients, and stimulate further progress in IOL formula research.

Invited Commentary