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In This Issue of JAMA Ophthalmology
June 2018


JAMA Ophthalmol. 2018;136(6):607. doi:10.1001/jamaophthalmol.2017.3728

Lee and coauthors evaluated whether there was a difference in access to eye care appointments between patients with Medicaid and those with private health insurance. In their cohort study of 330 unique eye care professionals in Michigan and Maryland, stratified by urban vs rural neighborhood, the proportion of callers who successfully obtained eye care appointments for adults and children with Medicaid was less than that of those with private health insurance. However, there was no difference identified in appointment wait times once an appointment was made. Their findings suggest that difficulty obtaining appointments may explain, in part, the lower rates of use of recommended eye care services among those with Medicaid.

Tamez and coauthors note that unverifiable publications in applications for ophthalmology residencies could be a serious concern if they represent publication dishonesty. They sought to determine how common unverifiable publications were among ophthalmology residency applications. In their cross-sectional study of 322 applicants invited to interview for the ophthalmology residency program at Vanderbilt University School of Medicine for entering classes 2012 to 2017, 7% had an unverifiable publication. Of students listing any full-length publications, 9% had at least 1 unverifiable scholarly work. Their findings show that unverifiable publications are not rare among ophthalmology residency applicants; the authors suggest modifying the San Francisco Match application to help ensure that ophthalmology residents are recruited with fewer or no unverifiable publications.

Invited Commentary

Author Audio Interview and CME

Friedman and coauthors question how treatment of retinoblastoma is associated with patient-reported vision-related quality of life during adulthood. In their cohort study, ocular, including visual problems, were associated with patient-reported vision-related quality of life in adult retinoblastoma survivors, particularly among those with a history of bilateral disease or enucleation. While there were some deficits in a few domains, overall patient-reported vision-related quality of life was largely preserved in this cohort treated for eye tumors at a very young age. Their study supports the need for continued development of vision-preserving and eye-sparing procedures in the treatment of retinoblastoma, when appropriate, and suggests long-term survivors should be assessed for specific areas of need to strive for optimization of supportive services.

Holz and coauthors evaluated whether lampalizumab reduced enlargement of geographic atrophy (GA) secondary to age-related macular degeneration in 2 phase 3 randomized clinical trials. The authors reported no meaningful differences in the primary end point, mean change from baseline in size of geographic atrophy lesions at week 48 among eyes receiving 10-mg lampalizumab injections either every 4 weeks or every 6 weeks vs sham. There was relatively substantial and consistent enlargement of GA, at a mean of approximately 2 mm2 over 48 weeks. The phase 3 trials showed that lampalizumab was ineffective as a treatment for GA secondary to age-related macular degeneration.

Continuing Medical Education