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In This Issue of JAMA Ophthalmology
July 2013


JAMA Ophthalmol. 2013;131(7):827. doi:10.1001/jamaophthalmol.2013.4121


Chew and colleagues evaluated lutein/zeaxanthin supplementation for the treatment of age-related cataract, a leading cause of blindness in the United States, with more than 30 million individuals likely to be affected by 2020. In a randomized clinical trial of 3159 phakic participants with varying degrees of age-related macular degeneration, there was no statistically significant effect of supplementation of lutein/zeaxanthin, 10 mg/2 mg, for cataract surgery or the development of cortical and posterior subcapsular cataracts. For participants with the lowest quintile of dietary intake of lutein/zeaxanthin, there was a beneficial effect.

Continuing Medical Education

A retrospective analysis of 32 cases of giant (>10 mm diasadfasdfmeter) conjunctival nevus, involving the cornea, limbus, bulbar conjunctiva, fornix, and tarsus, by C. L. Shields and colleagues revealed mean diameter of 16 mm (range, 10-40 mm) and mean thickness of 2 mm. Intrinsic cysts (78%) and intrinsic blood vessels (81%) were noted. Management included excisional biopsy with cryotherapy (72%) and observation (28%). Melanoma developed in 1 case after 23 years of observation.

Continuing Medical Education

Sheyman and colleagues reported the first outbreak of infectious fungal endophthalmitis after intravitreal injection of combined bevacizumab and triamcinolone. The medical records of all eight patients receiving intravitreal injections of this contaminated medicine prepared by the same pharmacy, with treatment based on clinical examination findings and knowledge of the etiology of endophthalmitis. Bipolaris hawaiiensis was the identified causative agent in this series.

The incidence of diabetic macular edema (DME) in eyes undergoing cataract extraction is variable. In a prospective observational study involving participants with diabetes mellitus from 45 sites across the United States, the Diabetic Retinopathy Clinical Research Network assessed the 16-week postoperative incidence of the development or worsening of macular edema in 329 eyes that did not have DME at the time of cataract extraction. The study concluded that postoperative development or worsening of macular edema in these eyes may be influenced by the presence of preexisting noncentral DME and history of DME treatment.

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