September 2016, Vol 134, No. 9, Pages 957-1075

In This Issue of JAMA Ophthalmology

Highlights

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JAMA Ophthalmol. 2016;134(9):957. doi:10.1001/jamaophthalmol.2015.3256

Original Investigation

Visual Function, Social Position, and Health and Life Chances: The UK Biobank Study

Phillippa M. Cumberland, MSc; Jugnoo S. Rahi, PhD, FRCOphth; for the UK Biobank Eye and Vision Consortium

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JAMA Ophthalmol. 2016;134(9):959-966. doi:10.1001/jamaophthalmol.2016.1778

This population-based UK Biobank study examines the association between visual function and socioeconomic status and health and social outcomes in UK adults with gradients of visual impairment from mild to complete blindness.

Assessment of the American Board of Ophthalmology’s Maintenance of Certification Part 4 (Improvement in Medical Practice)

Robert E. Wiggins Jr, MD, MHA; Rebecca Etz, PhD

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JAMA Ophthalmol. 2016;134(9):967-974. doi:10.1001/jamaophthalmol.2016.1848

This study evaluates the effectiveness of the American Board of Ophthalmology’s Maintenance of Certification Part 4 (Improvement in Medical Practice) in assisting its diplomates with quality improvement in their practices.

Invited Commentary
The Value of Maintenance of Certification
Hilary A. Beaver, MD

Effect of Pilocarpine Hydrochloride on the Schlemm Canal in Healthy Eyes and Eyes With Open-Angle Glaucoma

Alon Skaat, MD; Michael S. Rosman, BA; Jason L. Chien, BS; et al.

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JAMA Ophthalmol. 2016;134(9):976-981. doi:10.1001/jamaophthalmol.2016.1881

This case-control study investigates the effect of pilocarpine on the structure of the Schlemm canal in vivo in healthy eyes and eyes with glaucoma.

Invited Commentary
Novel Technology for Locating Hidden Egyptian Tombs and Detailing Schlemm Canal Physiology
L. Jay Katz, MD

Potential Role of In Vivo Confocal Microscopy for Imaging Corneal Nerves in Transthyretin Familial Amyloid Polyneuropathy

Antoine Rousseau, MD; Cecile Cauquil, MD; Benedicte Dupas, CO; et al.

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JAMA Ophthalmol. 2016;134(9):983-989. doi:10.1001/jamaophthalmol.2016.1889

This cross-sectional study evaluates the use of in vivo confocal microscopy to monitor patients with familial amyloid polyneuropathy through measurement of corneal nerve fiber length.

Invited Commentary
Confocal Microscopy of Corneal Nerves—a Limited but Still Useful Technique to Evaluate Peripheral Neuropathies
Timo Tervo, MD, PhD; Juha Holopainen, MD, PhD; Carlos Belmonte, MD, PhD

Characterization of CDH3-Related Congenital Hypotrichosis With Juvenile Macular Dystrophy

Sarah Hull, MA, FRCOphth; Gavin Arno, PhD; Anthony G. Robson, MSc, PhD; et al.

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JAMA Ophthalmol. 2016;134(9):992-1000. doi:10.1001/jamaophthalmol.2016.2089

This case series characterizes the clinical characteristics and course of patients with hypotrichosis with juvenile macular dystrophy due to biallelic mutations in the CDH3 gene, including OCT and macular electrophysiologic findings.

Assessment of the Accuracy of Using ICD-9 Codes to Identify Uveitis, Herpes Zoster Ophthalmicus, Scleritis, and Episcleritis

Matthew A. Pimentel, BS; Erica N. Browne, MS; Priya M. Janardhana, MD; et al.

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JAMA Ophthalmol. 2016;134(9):1001-1006. doi:10.1001/jamaophthalmol.2016.2166

This study uses Kaiser Permanente administrative data to assess the predictive value of ICD-9 codes for identifying ocular inflammatory diseases.

Association Between Diabetes-Related Eye Complications and Symptoms of Anxiety and Depression

Gwyneth Rees, PhD; Jing Xie, PhD; Eva K. Fenwick, PhD; et al.

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JAMA Ophthalmol. 2016;134(9):1007-1014. doi:10.1001/jamaophthalmol.2016.2213

This cross-sectional study uses Diabetes Management Project data to evaluate the association between severity of diabetic retinopathy and diabetic macular edema and symptoms of depression and anxiety in adults.

Invited Commentary
Depressive Symptoms in Ophthalmology Patients
Peter V. Rabins, MD, MPH

Current and Future Status of Diversity in Ophthalmologist Workforce

Imam M. Xierali, PhD; Marc A. Nivet, EdD; M. Roy Wilson, MD

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JAMA Ophthalmol. 2016;134(9):1016-1023. doi:10.1001/jamaophthalmol.2016.2257

This study assesses the current and future status of diversity among ophthalmologists in the workforce by sex, race, and ethnicity in the context of the available number of medical students in the United States.

Surveillance Tools Emerging From Search Engines and Social Media Data for Determining Eye Disease Patterns

Michael S. Deiner, PhD; Thomas M. Lietman, MD; Stephen D. McLeod, MD; et al.

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JAMA Ophthalmol. 2016;134(9):1024-1030. doi:10.1001/jamaophthalmol.2016.2267

This study investigates correlations between clinical diagnoses of conjunctivitis made at an academic medical center and Tweets related to the disease or Google searches for conjunctivitis keywords.

Invited Commentary
The Utility of “Big Data” and Social Media for Anticipating, Preventing, and Treating Disease
Alfred Sommer, MD, MHS

Evaluation of a Myopic Normative Database for Analysis of Retinal Nerve Fiber Layer Thickness

Sayantan Biswas, MPhil; Chen Lin, BM; Christopher K. S. Leung, MD

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JAMA Ophthalmol. 2016;134(9):1032-1039. doi:10.1001/jamaophthalmol.2016.2343

This study evaluates the diagnostic performance of a myopic normative database for detection of retinal nerve fiber layer abnormalities in eyes with high myopia.

Invited Commentary
Optical Coherence Tomography in High Myopia
Joel S. Schuman, MD

Journal Club

Evaluating the Validity of the Age-Related Eye Disease Study Grading Scale for Age-Related Macular Degeneration: AREDS2 Report 10

Susan Vitale, PhD, MHS; Traci E. Clemons, PhD; Elvira Agrón, MA; et al.

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JAMA Ophthalmol. 2016;134(9):1041-1047. doi:10.1001/jamaophthalmol.2016.2383

This study evaluates the validity of the Age-Related Eye Disease Study (AREDS) detailed and simple age-related macular disease (AMD) severity scales by comparing rates of development of late AMD between AREDS and AREDS2 participants.

Invited Commentary
Clinical Relevance and Application of the Age-Related Eye Disease Study Severity Scale for Age-Related Macular Degeneration
Chui Ming Gemmy Cheung, FRCOphth; Tien Yin Wong, MBBS, PhD, FRCS(Ed)

Brief Report

Expanding the Phenotype of TRNT1-Related Immunodeficiency to Include Childhood Cataract and Inner Retinal Dysfunction

Sarah Hull, MA, FRCOphth; Aeesha N. J. Malik, MRCP, FRCOphth; Gavin Arno, PhD; et al.

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JAMA Ophthalmol. 2016;134(9):1049-1053. doi:10.1001/jamaophthalmol.2015.5833

This study characterizes ocular and systemic findings in 3 consanguineous siblings homozygous for a TRNT1 mutation.

Assessment of the Incorporation of Patient-Centric Outcomes in Studies of Minimally Invasive Glaucoma Surgical Devices

Jimmy T. Le, MA; Shilpa Viswanathan, PhD; Michelle E. Tarver, MD, PhD; et al.

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JAMA Ophthalmol. 2016;134(9):1054-1056. doi:10.1001/jamaophthalmol.2016.2101

This study examines how often existing clinical studies of minimally invasive glaucoma surgical devices registered on ClinicalTrials.gov measure patient-centric outcomes that patients value directly.

Comparison of In Vivo Confocal Microscopy, Ultrasonic Pachymetry, and Scheimpflug Topography for Measuring Central Corneal Thickness

Soundaram MeenakshiSundaram, MD; Aalia Rasool Sufi, MD; N. Venkatesh Prajna, MD; et al.

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JAMA Ophthalmol. 2016;134(9):1057-1059. doi:10.1001/jamaophthalmol.2016.2183

This cross-sectional study compares measures of central corneal thickness in patients with keratoconus and normal corneas using in vivo confocal microscopy, ultrasonic pachymetry, and Scheimpflug topography.

Photobleaching by Spectralis Fixation Target

Livia Tomasso, MDs; Lucia Benatti, MD; Adriano Carnevali, MD; et al.

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JAMA Ophthalmol. 2016;134(9):1060-1062. doi:10.1001/jamaophthalmol.2016.2283

This study of healthy volunteers investigates whether the cross-shaped fixation target in Spectralis spectral-domain OCT produces a cross-shaped increase in macular autofluorescence on subsequent imaging.

Invited Commentary

The Value of Maintenance of Certification

Hilary A. Beaver, MD

Abstract Full Text

JAMA Ophthalmol. 2016;134(9):974-975. doi:10.1001/jamaophthalmol.2016.1694

Novel Technology for Locating Hidden Egyptian Tombs and Detailing Schlemm Canal Physiology

L. Jay Katz, MD

Abstract Full Text

JAMA Ophthalmol. 2016;134(9):982. doi:10.1001/jamaophthalmol.2016.2015

Confocal Microscopy of Corneal Nerves—a Limited but Still Useful Technique to Evaluate Peripheral Neuropathies

Timo Tervo, MD, PhD; Juha Holopainen, MD, PhD; Carlos Belmonte, MD, PhD

Abstract Full Text

JAMA Ophthalmol. 2016;134(9):990-991. doi:10.1001/jamaophthalmol.2016.2178

Depressive Symptoms in Ophthalmology Patients

Peter V. Rabins, MD, MPH

Abstract Full Text

JAMA Ophthalmol. 2016;134(9):1015. doi:10.1001/jamaophthalmol.2016.2367

The Utility of “Big Data” and Social Media for Anticipating, Preventing, and Treating Disease

Alfred Sommer, MD, MHS

Abstract Full Text

JAMA Ophthalmol. 2016;134(9):1030-1031. doi:10.1001/jamaophthalmol.2016.2287

Optical Coherence Tomography in High Myopia

Joel S. Schuman, MD

Abstract Full Text

JAMA Ophthalmol. 2016;134(9):1040. doi:10.1001/jamaophthalmol.2016.2017

Clinical Relevance and Application of the Age-Related Eye Disease Study Severity Scale for Age-Related Macular Degeneration

Chui Ming Gemmy Cheung, FRCOphth; Tien Yin Wong, MBBS, PhD, FRCS(Ed)

Abstract Full Text

JAMA Ophthalmol. 2016;134(9):1047-1048. doi:10.1001/jamaophthalmol.2016.2407

JAMA Ophthalmology Clinical Challenge

An Iris Tumor

Rajesh C. Rao, MD; J. William Harbour, MD

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JAMA Ophthalmol. 2016;134(9):1063-1064. doi:10.1001/jamaophthalmol.2016.0924

A woman in her 50s with an unremarkable medical history noticed a gradually enlarging, white-brown, circular lesion on her right iris over the past several years but denied visual changes. Slitlamp examination of the anterior segment showed a 2 mm × 2 mm circular iris lesion at the inferotemporal border of the iris with a fluid-debris level. What would you do next?

Persistent Blurry Vision After a Routine Eye Examination

Aubrey L. Gilbert, MD, PhD; Aristomenis Thanos, MD; Roberto Pineda, MD

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JAMA Ophthalmol. 2016;134(9):1065-1066. doi:10.1001/jamaophthalmol.2016.0812

An otherwise healthy woman in her 50s presented with blurry vision in both eyes after a routine eye examination with dilation 5 days earlier. The pupils were middilated and poorly reactive, and the lenses were displaced into the anterior chambers without any lenticular zonules visible. What would you do next?

Fluocinolone Acetonide Intravitreal Implant in the Visual Axis

Elad Moisseiev, MD; Lawrence S. Morse, MD, PhD

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JAMA Ophthalmol. 2016;134(9):1067-1068. doi:10.1001/jamaophthalmol.2016.0807

A man in his 40s who had previously undergone several treatments for diabetic macular edema without improving visual acuity past 20/70 OD had a fluocinolone acetonide intravitreal implant injected; soon after, the implant was seen in the middle of the vitreous cavity in a vertical orientation and in the visual axis. What would you do next?

Leukocoria and Decreased Vision Detected During a Routine Pediatric Screening Eye Examination

Mohsin H. Ali, MD; Felix Y. Chau, MD; Javaneh Abbasian, MD

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JAMA Ophthalmol. 2016;134(9):1069-1070. doi:10.1001/jamaophthalmol.2016.1687

A 2-year-old African American boy with leukocoria in his left eye noted during a routine well-child visit was unable to read the distance chart, had an APD and a white-yellow mass in the macula OS. What would you do next?

Research Letter

Variation in Ophthalmologist Use of Antivascular Endothelial Growth Factor Therapy Among Medicare Beneficiaries

Rachel V. Thakore, BS; Paul B. Greenberg, MD; Jess J. Behrens, MS; et al.

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JAMA Ophthalmol. 2016;134(9):1071-1072. doi:10.1001/jamaophthalmol.2016.2051

This study compares the use of lower- vs higher-cost antivascular endothelial growth factor drugs prescribed for treatment of retinal vascular diseases in the Medicare population.

Observation

Unusual Retinal Vascular Proliferation in von Hippel-Lindau Disease

Farrah Islam, FCPS, FRCS; Sarah Hull, MA, FRCOphth; David C. Mansfield, PhD, FRCOphth; et al.

Abstract Full Text

JAMA Ophthalmol. 2016;134(9):1073-1074. doi:10.1001/jamaophthalmol.2016.2046

This case report describes a patient with a retinal vascular complex that most likely represents a developmental abnormality of the retinal vasculature, consistent with the role of von Hippel-Lindau disease in retinal vascular development.

Ophthalmic Images

Spontaneous Devascularization and Detachment of Optic Nerve Hemangioblastoma in a Patient With Von Hippel-Lindau Disease

Elif Betul Turkoglu, MD; Emil Anthony T. Say, MD; Carol L. Shields, MD

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JAMA Ophthalmol. 2016;134(9):e161119. doi:10.1001/jamaophthalmol.2016.1119

This case report describes a woman in her 30s with known von Hippel-Lindau disease who had spontaneous devascularization and detachment of an optic nerve hemangioblastoma.

Incarceration of Lens Capsular Material in a Tube Shunt in an Aphakic, Vitrectomized Infant Eye

Ta C. Chang, MD; Brenda Fallas, BS; Kara M. Cavuoto, MD

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JAMA Ophthalmol. 2016;134(9):e161309. doi:10.1001/jamaophthalmol.2016.1309

This case report describes an aphakic young child with glaucoma associated with infantile cataract surgery and a previously functioning nonvalved glaucoma drainage device who presented with sudden-onset pain and increased eye pressure.

Macular Retinal Cavernous Hemangioma Associated With Congenital Retinal Macrovessel

Aristomenis Thanos, MD; Sandeep Randhawa, MD; Kimberly A. Drenser, MD, PhD

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JAMA Ophthalmol. 2016;134(9):e161683. doi:10.1001/jamaophthalmol.2016.1683

This case report describes a man in his 20s with blurry vision in his right eye who had a macular lesian on fluorescein angiography.

Demonstration of Choroidal Neovascularization Associated With an Intraretinal Lesion on Indocyanine Green Angiography Independent of Choroidal New Vessel on Optical Coherence Tomography

Federico Corvi, MD; Francesco Bandello, MD, FEBO; Giuseppe Querques, MD, PhD

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JAMA Ophthalmol. 2016;134(9):e162687. doi:10.1001/jamaophthalmol.2016.2687

This case report describes woman in her late 70s with decreased visual acuity in the right eye, which on imaging showed leakage at the level of the inner retina due to an intraretinal vascular complex and, separately, choroidal neovascularization under the retinal pigment epithelium.

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