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In This Issue of JAMA Ophthalmology
March 2014


JAMA Ophthalmol. 2014;132(3):241-372. doi:10.1001/jamaophthalmol.2013.5928


Rautiainen and colleagues investigated the association between the total antioxidant capacity of the diet and the incidence of age-related cataract in a population-based prospective cohort of middle-aged and elderly women. Using a questionnaire-based nutrition survey within the prospective Swedish Mammography Cohort Study, which included 30 607 women (aged 49-83 years) observed for age-related cataract incidence for a mean of 7.7 years, the multivariable rate ratio in the highest quintile of the total antioxidant capacity of the diet compared with the lowest was 0.87 (95% CI, 0.79-0.96; P for trend = .03). Future studies examining all antioxidants in the diet in relation to age-related cataract are needed to confirm or refute their findings.

Journal Club

Cheng and colleagues aimed to determine whether bifocal and prismatic bifocal spectacles control myopia in children with high rates of myopia progression in a randomized clinical trial within a community-based practice. Myopia progression using an automated refractor following cycloplegia and increase in axial length (secondary) measured using ultrasonography over 3 years showed that bifocal spectacles can slow myopia progression in children with an annual progression rate of at least 0.50 D after 3 years. These results suggest that prismatic bifocals are more effective for myopic children with low lags of accommodation.

Author Audio Interview

Providing long-term follow-up of the natural history of age-related macular degeneration (AMD) and associated risk factors will facilitate future epidemiologic studies and clinical trials. Chew and colleagues described 10-year progression rates to the intermediate or advanced stages of AMD. In the oldest participants with the most severe AMD status at baseline, the risks for developing neovascular AMD and central geographic atrophy by 10 years were 48.1% and 26.0%, respectively. Meanwhile, median visual acuity at 10 years in eyes that had large drusen at baseline but never developed advanced AMD was 20/25. These progression data and the risk factor analyses may be helpful to investigators conducting research in clinic populations.

Continuing Medical Education

Journal Club

To document photoreceptor and retinal pigmented epithelial cell loss in donated human eyes in which visual loss was deemed to be due to geographic atrophy (GA), Bird and colleagues reported a histopathological assessment of GA among a consecutive series of eyes donated by individuals previously diagnosed clinically as having GA. In most of the 37 donors examined, there was marked loss of photoreceptor cells for variable distances distal from the edge of the GA, with rod loss greater than cone loss. The findings imply that photoreceptor cell loss may contribute to functional vision loss recorded in early stages of age-related macular degeneration.