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June Issue BJO
Temporary monocular blindness is a risk factor for stroke and may need quick surgical therapy. The highest risk period for suffering a stroke after a temporary monocular blindness or amaurosis fugax is the first 14 days after the event, and this is the recommended threshold for performing carotid endarterectomy. Naylor and colleagues stress the importance of referring ophthalmological patients presenting with transient monocular blindness (or blindness felt to be “monocular”) to stroke units for further diagnosis and therapy of a potential carotid artery stenosis.1
Purulent Conjunctivitis I Children
In an international multicentre randomised, investigator-masked study in 286 children with purulent discharge and bulbar conjunctival injection, Bremond-Gignac et al. found that azithromycin 1.5% eye drops provided a more rapid clinical cure than tobramycin 0.3% eye drops, with a more convenient twice-a-day dosing regimen.2
Imaging of Meibom glands
Arita and coworkers developed a non-contact infrared meibography technique for the non-contact observation of the Meibomian glands.3 Future studies may address the practicability of the new technique in clinical routine of patients with Meibomian gland dysfunctions or tumors.
Zig Zag versus Top Hat configuration in IntraLase-enabled penetrating Keratoplasty
In a retrospective clinical study, Shehadeh Mashor et al. examined the outcome of penetrating keratoplasty using the femtosecond laser enabled cut configuration of Top Hat (24 eyes) versus the Zig Zag configuration (10 eyes).4 At one year follow-up, both groups did not markedly differ in visual and refractive outcomes, wound healing and corneal endothelial cell counts.
Community optometrist-delivered postoperative follow-up of patients after cataract surgery
Voyatzis and colleagues evaluated a community optometrist-delivered postoperative discharge scheme in patients who underwent same day discharge from the hospital eye service following cataract surgery. They found that the system by the community optometrists combined the advantages of care closer to home and avoided unnecessary hospital visits for patients undergoing uncomplicated cataract surgery.
Air by Vitrectomy Embolization (PAVE)
In an experimental post mortem study on human globes, Morris et al. describe the possibility of an intrusion of air into the vortex veins if air gets access to the suprachoroidal space during vitrectomy.6 This mechanism could explain the development of fatal air embolizations in patients undergoing pars plana vitrectomy with fluid-air exchange. The authors strongly recommend avoiding any access of air into the suprachoroidal space during surgery.
Genomic examination in patients with uveal melanomas
Cassoux and colleagues investigated the capacity of a genetic analysis of uveal melanoma samples to identify patients with uveal melanoma at high risk for eventual metastasis.7 The status of chromosome 3 and 8 was determined by array comparative genomic hybridization. The study population was divided into groups of patients with disomy 3 and normal chromosome 8, disomy 3 and 8q gain, monosomy 3 and normal chromosome 8, and monosomy 3 and 8 or 8q gain. After a median follow-up of 28 months, multivariate Cox modelling analysis revealed that the status of chromosomes 3 and 8 were the only two variables that independently contributed to the prognosis: monosomy 3 alone (p=0.001) and monosomy 3 and 8q gain (p<0.0001). The authors recommend applying array comparative genomic hybridization for assessing the risk of metastasis in patients with uveal melanomas.
Toxic irradiated tumour syndrome
Konstaninidis et al. report that trans-scleral local resection of irradiated uveal melanomas can resolve exudative retinal detachment, rubeosis iridis and neovascular glaucoma which developed after the irradiation.8 The authors conclude that the complications exudative retinal detachment and neovascular glaucoma may be caused by the persistence of the irradiated tumor masses within the eye as part of a ‘toxic tumour syndrome’.
Fundus autofluorescence and treatment for polypoidal choroidal vasculopathy
Yamagishi et al report on the elimination of a hyper-autofluorescent ring around polyps in patients with polypoidal choroidal vasculopathy after successful therapy.9 The authors suggest that examination of the fundus autofluorescence could be a useful diagnostic tool in assessing the therapeutic outcome in patients with polypoidal choroidal vasculopathy.