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Oral Antithrombotic Therapies and Intraocular Bleeding
Uyhazi and coauthors evaluate whether novel anticoagulant and antiplatelet agents are better, the same, or worse than traditional agents regarding the risk of intraocular hemorrhages in a cohort study. Two novel anticoagulant agents, dabigatran etexilate and rivaroxaban, had a 25% decreased hazard of intraocular hemorrhages compared with warfarin sodium. No difference in the hazard of intraocular hemorrhages was identified for the antiplatelet agent prasugrel hydrochloride compared with clopidogrel bisulfate. The findings suggest that novel antithrombotic agents are, at worst, equal in the risk of intraocular hemorrhages and in some instances are safer than their traditional counterparts.
Electronic Health Records Among US Ophthalmologists
To assess the rate of electronic health record (EHR) adoption and ophthalmologists’ perceptions on financial and clinical productivity, Lim and coauthors investigate the EHR adoption rate among US ophthalmologists and their perception of financial and clinical productivity following implementation. In a population-based, cross-sectional survey, the adoption rate of EHRs among ophthalmologists was 72.1%. Ophthalmologists reported that their net revenues and productivity have declined and that practice costs are higher with EHR use. The authors conclude that not only has the EHR adoption rate doubled since a previous EHR survey of US ophthalmologists in 2011, but a comparison with 2 previous EHR surveys suggests perceptions of practice costs and clinical productivity are more negative.
Continuing Medical Education
Using Video Games to Improve Visual Functions
To compare the effectiveness of a binocular video game with a placebo video game for improving visual functions in older children and adults, Gao and coauthors investigate whether a home-based binocular video game is more effective than a placebo video game for improving amblyopic eye visual acuity in older children and adults with unilateral amblyopia. In a randomized clinical trial including 115 participants aged 7 to 55 years, no differences were detected between the binocular video game treatment group and the placebo video game treatment group in amblyopic eye visual acuity after 6 weeks. The authors conclude that the home-based binocular video game used in this study does not improve visual function compared with the placebo video game.
Optical Coherence Tomography in Astronauts
After long-duration spaceflight, morphologic changes in the optic nerve head and surrounding tissues have been reported, but the cause remains unknown. Patel and coauthors evaluate if optical coherence tomography technology can be used to quantify changes in the posterior segment after spaceflight. In a study comparing 15 preflight and postflight optical coherence tomographic scans, there was an increase in total retinal thickness and retinal nerve fiber layer thickness of up to 1000 μm from the Bruch membrane opening. There also was a downward deflection of the Bruch membrane opening and an increase in choroidal folds after spaceflight. Although some postflight changes are similar to those with elevated intracranial pressure, the downward deflection of the Bruch membrane opening height and substantial increase in choroidal folds is not, suggesting an alternate hypothesis should be pursued for spaceflight-associated neuro-ocular syndrome.
Highlights. JAMA Ophthalmol. 2018;136(2):107. doi:10.1001/jamaophthalmol.2017.3708
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