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In This Issue of JAMA Ophthalmology
August 2019


JAMA Ophthalmol. 2019;137(8):865. doi:10.1001/jamaophthalmol.2018.4783


Grassmann and coauthors conduct a pooled analysis combining data from 4 independent studies assessing progression of geographic atrophy. The correlation between square root–transformed geographic atrophy growth rate and more than 7 million genetic variants was estimated, and 2 gene loci with genome-wide significance were identified as geographic atrophy progression–associated candidates: protein arginine methyltransferase 6 (chromosome 1) and lanosterol synthase (chromosome 21). These 2 loci as geographic atrophy progression–associated candidates provide a basis for future functional studies exploring mechanisms of atrophic lesion growth.

Invited Commentary

Chellappa and coauthors investigate the association of intraocular cataract lens (IOL) replacement with circadian rhythms, cognitive function, and sleep. In their cross-sectional study of 13 patients with previous cataract and 16 healthy controls, IOL replacement increased melatonin sensitivity to light by approximately 45%, ultraviolet lens improved cognitive function by approximately 70%, and sleep function by approximately 50% compared with blue-blocking lens. These in-laboratory empirical findings suggest that optimizing the spectral lens transmission in patients with cataract may be associated with better circadian, cognitive, and sleep function.

Invited Commentary

Continuing Medical Education

Bez and coauthors evaluate the association between the prevalence and severity of myopia and different study styles. In an Israeli cross-sectional study that included 22 823 male adolescents, the odds of having myopia for those who were studying in the ultra-Orthodox and Orthodox educational systems were much higher compared with adolescents in the secular educational system. These findings suggest that educational systems that require extensive reading and other near-work activities (those done at a short working distance) are associated with increased prevalence and severity of myopia.

Invited Commentary

Bodnar and coauthors describe how ophthalmic digital devices might be evaluated for safety and effectiveness to streamline innovation based on a workshop on ophthalmic digital devices comprising regulators, health care practitioners, researchers, medical device firms, mobile application developers, patients, and other stakeholders. The authors concluded that because the risks associated with automation are substantially increased in rapidly progressive diseases, criterion standards and expert graders are critically important in the evaluation of automated systems and telemedicine platforms. Training at all levels is important for the safe and effective operation of digital health devices and to promote cybersecurity and protect patient privacy. The authors conclude that with appropriate validation against criterion standards, physician oversight, and robust cybersecurity protocols, digital health technology could improve screening and treatment of ophthalmic diseases and improve access to care.