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In This Issue of JAMA Ophthalmology
October 2018

Highlights

JAMA Ophthalmol. 2018;136(10):1086. doi:10.1001/jamaophthalmol.2017.3748

Research

Although reading is a visual task, the potential role of vision in developmental dyslexia (DD) is controversial. Raghuram and coauthors assessed the frequency of visual deficits (vergence, accommodation, and ocular motor tracking) in school-aged children with DD compared with a control group of typically developing readers. On average, children with DD exhibited more deficits in visual function than did the nonrandomized control group of typically developing children. These findings suggest that visual function deficits contribute to reading acquisition in children with DD, but further study is needed to determine the extent to which treating these deficits can improve visual symptoms or reading parameters.

Invited Commentary

Continuing Medical Education

Because some evidence in the literature suggests that patients of African descent experience higher surgical failure rates after trabeculectomy without antimetabolites, Nguyen and coauthors compare outcomes of initial trabeculectomy with mitomycin C in patients of African descent with those of patients of European descent and identify prognostic factors for failure. In a matched cohort study of 222 patients, success rates of initial trabeculectomy with mitomycin C were worse in patients of African descent compared with patients of European descent when more stringent criteria for success were used. These findings suggest that the role of nonfiltering glaucoma surgeries in patients of African descent needs further investigation.

Invited Commentary

Continuing Medical Education

Gross and coauthors for the Diabetic Retinopathy Clinical Research Network compared the efficacy and safety of intravitreous ranibizumab vs panretinal photocoagulation over 5 years for treatment of patients with proliferative diabetic retinopathy. In this randomized clinical trial of 305 participants, loss to follow-up was relatively high, but visual acuity in most study eyes that completed follow-up was very good in both groups at 5 years, consistent with 2-year results. While severe vision loss or serious proliferative diabetic retinopathy complications were uncommon in either group, the ranibizumab group, on average, had less peripheral visual field loss, lower rates of developing vision-impairing diabetic macular edema or retinal detachment, and more visits and injections. These findings support either ranibizumab or panretinal photocoagulation as viable treatments for proliferative diabetic retinopathy; the authors recommend that patient-specific factors, including anticipated visit compliance, cost, and frequency of visits, should be considered when choosing a treatment for patients with proliferative diabetic retinopathy.

Niziol and coauthors evaluate the association of disease trajectory and need for treatment between the 2 eyes of a patient with glaucoma. In a post hoc analysis of 607 participants, 414 (68.2%) had bilateral treatment for glaucoma within 7 years after initial treatment, with a correlation observed between eyes on mean deviation trajectories. Characteristics associated with an increased hazard of fellow eye treatment included older age, hypertension, higher intraocular pressure, large cup-disc ratio, and worse mean deviation. The findings suggest that most patients with unilateral glaucoma will develop bilateral glaucoma and therefore should be closely monitored, especially if disease progression is noted in the initially diagnosed eye.

Invited Commentary

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