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In This Issue of JAMA Ophthalmology
November 2016

Highlights

JAMA Ophthalmol. 2016;134(11):1213. doi:10.1001/jamaophthalmol.2015.3268
Research

Because the public health success of diabetic retinopathy screening programs depends, in part, on patients’ adherence to the timetable of follow-up eye care recommended by the screening program, Keenum and coauthors evaluate to what extent patients with diabetes in a diabetic retinopathy screening program adhere to the timetable of recommended follow-up eye examinations. In a follow-up study, only about 30% of patients adhered to recommendations to have an eye examination within the indicated time frames, even when cost and accessibility were minimized as barriers. Two years later, about half of the patients still had not undergone an eye examination. These data suggest that diabetic retinopathy screening programs may need additional strategies that can address limitations of patients to adhere to eye care follow-up recommendations.

Invited Commentary

Because there are few studies investigating the prevalence of noninfectious uveitis overall or stratified by inflammation location, severity, presence of systemic conditions, age, or sex, Thorne and colleagues investigate the prevalence of noninfectious uveitis among adults and children stratified by age, sex, and location of inflammation. The authors used a large US administrative insurance claims database and found that the prevalence of noninfectious uveitis among adults was 121 cases per 100 000 persons. Among children, the prevalence was 29 per 100 000 persons. Approximately 10% of anterior segment cases were receiving topical corticosteroid treatment.

Invited Commentary

With the development of increasingly effective treatments for retinopathy of prematurity (ROP), the importance of consistency of ROP findings has increased. Quinn and coauthors for the e-ROP Cooperative Group analyze the discrepancies between image grading and clinical examination findings in infants at risk for ROP. Consensus review of discrepant referral-warranted ROP findings (ie, eyes with zone I ROP, stage 3 ROP, or plus disease) by a panel of ROP experts found that nonphysician readers were less likely to detect stage 3 ROP than clinicians. However, trained readers were generally better than physicians at identifying the zone of ROP and presence of plus disease.

Invited Commentary

Recognizing that somatosensory dysfunction may underlie some dry eye symptoms in many individuals, Galor and coauthors suggest that this dysfunction remains an understudied component of the disease. The authors assess whether patients with dry eye and ocular pain symptoms have increased sensitivity to stimuli outside the trigeminal system, including measures specific for central sensitization. Using data from a prospective, cross-sectional study, the results demonstrated that individuals with neuropathic-like dry eye pain symptoms have increased pain sensitivity at a site remote from the eye, specifically using the forearm. This increased sensitivity included enhanced temporal summation, which is indicative of central sensitization. The findings of the study suggest that dry eye symptoms not only are manifestations of a local disorder but also involve somatosensory dysfunction beyond the trigeminal system.

Invited Commentary

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