Prager and colleagues assess self-reported medical conditions, the use of medical services, and total health care costs among Medicare beneficiaries with glaucoma. In a study of Medicare beneficiaries with and without a glaucoma diagnosis in the year before collection of survey data in the general community using the Medicare Current Beneficiary Survey (2004-2009), they found Medicare beneficiaries with glaucoma had higher adjusted odds of inpatient hospitalizations and home health aide visits compared with Medicare beneficiaries without glaucoma.
Invited Commentary
To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomographic (OCT) angiography, Hwang and colleagues evaluate 12 control individuals with normal vision and 12 patients with diabetic retinopathy (DR) within a 6 × 6-mm field on OCT angiography using an automated algorithm. Compared with controls, those with DR had reduced parafoveal and perifoveal vessel density by 12.6% and 10.4%, respectively. The agreement between the vascular areas in the OCT angiogram and fluorescein angiography had a κ value of 0.45. The findings suggest that avascular area analysis with an automated algorithm using OCT angiography, although not equivalent to fluorescein angiography, detects DR reliably, but its clinical relevance is unknown.
Invited Commentary
To investigate the risk for cataract after treatment of nonretinoblastoma solid cancer in childhood, Allodji and colleagues use data from the Euro2K cohort that includes 4389 5-year survivors of solid tumors treated from January 1, 1945, to December 31, 1985, with a self-reported questionnaire sent to French survivors from September 1, 2005, to December 31, 2012. Among the 1833 patients who returned the questionnaire, 33 patients with unilateral or bilateral cataract were identified, totaling 47 cataract events. In a multivariable Cox proportional hazard regression analysis, patients who received radiotherapy had a 4.4-fold increased risk for cataract compared with patients who did not receive radiotherapy. Exposure to radiation doses of at least 10 Gy to the eyes increased the hazard ratio 39-fold, relative to no radiation exposure.
Continuing Medical Education
Uhr and colleagues assess public awareness and knowledge of 4 emergent ophthalmic diseases in the waiting rooms of an outpatient internal medicine resident clinic. All English-speaking patients who were physically and cognitively able to fill out the survey without assistance were considered eligible and offered the opportunity to participate during times of survey distribution, resulting in 237 completing the survey. Awareness of each of the diseases studied was low; 61 of 220 respondents were aware of retinal detachment; 32 of 219 respondents, acute angle-closure glaucoma; 11 of 216 respondents, giant cell arteritis; and 10 of 218 respondents, central retinal artery occlusion. These results suggest a need to educate the public about these acutely vision-threatening entities.
Author Audio Interview and Journal Club