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In This Issue of JAMA Ophthalmology
August 2014


JAMA Ophthalmol. 2014;132(8):913. doi:10.1001/jamaophthalmol.2013.5953


Although anti–vascular endothelial growth factor treatment of neovascular age-related macular degeneration (AMD) results in improved vision on average within clinical trials, a minority of participants in those trials have substantial vision loss. To further understand features of sustained vision loss after 2 years of treatment with ranibizumab or bevacizumab for neovascular AMD, Ying and colleagues from the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT) evaluate 1030 participants, among which 61 eyes (5.9%) developed 15 or more letter loss 88 and 104 weeks after initiating therapy. The risk was 3% higher (odds ratio, 1.83; 95% CI, 1.07-3.14; P = .03) among bevacizumab-treated eyes.

Continuing Medical Education

To study changes associated with aging on refractive errors among Chinese adults, He and colleagues report on a 2-year, longitudinal population-based cohort study in southern China. Among 745 individuals, the mean (SD) refractive error showed a 2-year hyperopic shift from −0.44 (2.21) to −0.31 (2.26) diopters (difference, +0.13; 95% CI, 0.11-0.16).

Because there are limited reports on the relationship between mucin 5AC (MUC5AC) concentrations in tears, working hours, and the frequency of ocular symptoms in visual display terminal (VDT) users, Uchino and colleagues evaluate these relationships among patients with dry eye disease (DED) and individuals serving as controls among 96 young and middle-aged Japanese office workers. The prevalence of definite and probable DED was 9% (n = 9) and 57% (n = 55), respectively. The mean MUC5AC concentration was lower in the tears of VDT users with definite DED than in those with no DED (P = .02; Hodges-Lehmann estimator, −2.17; 95% CI, −4.67 to −0.30). The mean MUC5AC concentration in tears appeared to be lower in the group that worked longer hours than in the group that worked shorter hours (P = .049; estimated difference, −1.65; 95% CI, −3.12 to 0.00), suggesting that office workers with prolonged VDT use, as well as those with an increased frequency of eye strain, have a low MUC5AC concentration in their tears.

McCannel and colleagues report on a series of 3 patients with bilateral subfoveal neurosensory retinal detachments among patients with metastatic cancer undergoing systemic therapy with MEK inhibitors enrolled in clinical trials at the authors’ institution. One patient had metastatic uveal melanoma, another patient had metastatic cholangiocarcinoma, and one had metastatic rectal cancer. The findings in all 3 patients resolved with observation and topical corticosteroids for concomitant uveitis. No patient developed permanent ocular sequelae and none withdrew from the clinical trial..