Koh and coauthors evaluate whether there are any differences in treatment outcomes between combination therapy of intravitreal ranibizumab plus verteporfin photodynamic therapy compared with ranibizumab monotherapy for polypoidal choroidal vasculopathy in a multicenter randomized clinical trial. Among 322 Asian participants, treatment of polypoidal choroidal vasculopathy with ranibizumab plus verteporfin photodynamic therapy resulted in greater visual acuity improvement with monotherapy and greater likelihood of resolution of polypoidal lesions on indocyanine green angiography using fewer ranibizumab injections. These data suggest ranibizumab plus verteporfin photodynamic therapy should be considered as a viable treatment strategy for eyes with polypoidal choroidal vasculopathy.
Invited Commentary
Journal Club
Patel and Sternberg evaluate the trends in opioid prescribing among ophthalmologists. In an observational cohort study, the authors analyzed Medicare Part D Prescription Drug Program beneficiaries from 2013 to 2015 and found that 88% to 89% of ophthalmologists wrote 10 opioid prescriptions or fewer annually. Southern states in the United States tended to have a higher number of prescriptions written per physician. These results suggest ophthalmologists in general prescribe opioids responsibly; the current prescription opioid epidemic should prompt physicians to consider revisiting their opioid prescribing protocols.
Read-Brown and coauthors evaluate the time requirements for ophthalmologists’ use of electronic health records (EHRs). In a single-center cohort study of 27 ophthalmologists, mean total ophthalmologist examination time was 11.2 minutes per patient, of which 27% was spent on EHR use, 42% on conversation, and 31% on patient examination. The mean total ophthalmologist time spent using the EHR was 10.8 minutes per encounter, translating to 3.7 hours per day using the EHR (2.1 hours during patient examinations, and 1.6 hours outside the clinic session). Although simultaneous EHR and conversation or examination time were not determined, the study suggests that EHR use requires substantial time by ophthalmologists, with variability in EHR use patterns.
Invited Commentary
Korobelnik and coauthors investigate if macular pigment density increased with dietary supplementation containing lutein, zeaxanthin, ω-3 polyunsaturated fatty acids, and vitamins. Among 120 participants (239 eyes) in the randomized clinical trial, with a 6-month treatment period followed by a 6-month follow-up period, no increase in macular pigment optical density was observed when measured with the modified MPD-Visucam 200 (Carl Zeiss Meditec) or the modified Heidelberg Retina Angiograph (Heidelberg Engineering) in treated patients (n = 60) compared with patients receiving placebo (n = 60). The results suggest that macular pigment density may increase after dietary supplementation, but it is not measurable.
Invited Commentary
Journal Club