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Highlights from this issue
  1. Frank Larkin, Editor in Chief
  1. Moorfields Eye Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Frank Larkin, Moorfields Eye Hospital, London, UK; f.larkin{at}

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A case series of shrinking hydroxyapatite orbital implants (see page 1338)

Bone-derived hydroxyapatite orbital implants can reduce in size by osteoclastic activity in as little time as four years, requiring further intervention to maintain orbital volume.

Nationwide trends in the incidence of orbital lymphoma from 1999 to 2016 in South Korea (see page 1341)

Orbital lymphoma incidence is very low in South Korea but has increased recently. Orbital extranodal marginal zone B-cell lymphoma incidence is high in Koreans; older adults have lower survival rate for orbital soft tissue lymphomas.

UK National Artificial Eye Questionnaire study: comparisons between cosmetic shell and artificial eye users. Part 1: demographics, comfort and satisfaction (see page 1346)

In this large, national questionnaire study the reported experiences of cosmetic shell wearers were compared with those of artificial eye wearers. The results should reinforce the gain in popularity of cosmetic shells in applicable cases.

Palpebral lobe of the human lacrimal gland: morphometric analysis in normal versus dry eyes (see page 1352)

The morphological features of the palpebral lobe of the main lacrimal gland demonstrate a significant variation between normal and aqueous deficient dry eyes, however the lobes in evaporative dry eye patients and normal eyes are similar.

Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study (see page 1358)

This multicentre, international registry-based study on conjunctival melanoma showed that higher AJCC T- stage tumours were at greater risk for local tumour recurrence

Influence of corneal guttae and nuclear cataract on contrast sensitivity (see page 1365)

The contrast sensitivity in patients with a defined grade of nuclear cataract is further influenced by corneal guttae. Including the contrast sensitivity in the preoperative evaluation of patients with corneal guttae may be beneficial.

Factors affecting central corneal thickness measurement agreement between Scheimpflug imaging and ultrasound pachymetry in keratoconus (see page 1371)

The agreement of central corneal thickness measurements between Scheimpflug and ultrasound pachymetry in 794 keratoconic eyes was found to be moderate. Greater cone decentration and steeper maximal keratometry were factors significantly associated with reduced agreement

Clinical outcomes of KeraVio using violet light—emitting glasses and riboflavin drops for corneal ectasia: a pilot study (see page 1376)

KeraVio is a minimally invasive cross-linking process that uses violet light-emitting glasses and riboflavin drops, and it has been shown to halt disease progression in eyes with corneal ectasia

Glaucoma conversion of the contralateral eye in unilateral normal-tension glaucoma patients: a 5-year follow-up study (see page 1383)

In this retrospective observational cohort study, low central corneal thickness and high β-zone parapapillary atrophy width in the non-glaucomatous contralateral eye are identified as risk factors for glaucoma conversion of the contralateral eye.

Intraocular pressure-lowering medications during pregnancy and risk of neonatal adverse outcomes: a propensity score analysis using a large database (see page 1390)

Our database study showed that use of intraocular pressure-lowering medications during the first trimester of pregnancy was not significantly associated with a greater frequency of congenital anomalies, preterm birth, or low birth weight.

Rates of spondyloarthropathies vary with age and ethnicity in HLAB27 uveitis (see page 1395)

HLAB27-positive spondyloarthropathies include ankylosing spondylitis and psoriatic arthritis. Ankylosing spondylitis, the most common, is highest in ages 20–30 years. Chronic anterior uveitis is more common in psoriatic arthritis. There is no association with ethnicity.

Diagnostic value of lymphopaenia and elevated serum ACE in patients with uveitis (see page 1399)

The combination of elevated serum angiotensin-converting enzyme and lymphopaenia suggests sarcoid uveitis in nearly three quarters of all cases if both parameters are present, especially in patients with granulomatous uveitis.

Long-term natural history of highly myopic eyes with a dome-shaped macula with or without untreated serous retinal detachment: a 4-year follow-up study (see page 1405)

Visual acuity remained clinically stable over 4 years in myopic eyes with dome-shaped macula with or without untreated serous retinal detachment (SRD), regardless of the presence of SRD and its fluctuations. The amount of fluid is directly correlated with choroidal thickness, suggesting a possible explanation for the pathogenesis of the disease.

Peripheral exudative haemorrhagic chorioretinopathy: a widefield imaging study (see page 1410)

In peripheral exudative haemorrhagic chorioretinopathy subretinal fluid and lesion extension behave as risk factors for macular involvement. Intravitreal anti-VEGF injections and photodynamic therapy are warranted in eyes with risk factors.

Non-neovascular age-related macular degeneration with subretinal fluid (see page 1415)

Non-neovascular AMD with fluid is an important clinical entity to recognise to avoid unnecessary anti-VEGF therapy. Clinicians should be aware that SRF can be associated with drusen or drusenoid PED in the absence of MNV and may be the result of retinal pigment epithelial decompensation and RPE pump failure.

Fractal analysis of polypoidal choroidal neovascularization in age-related macular degeneration (see page 1421)

Fractal analysis of optical coherence tomography angiography (OCTA) images reveals that polypoidal choroidal neovascularization with different OCTA patterns share the same neovascular architecture and branching complexity.

Geographic distributions of age-related macular degeneration incidence: a systematic review and meta-analysis (see page 1427)

The pooled global annual incidences of early and late AMD were 1.59% and 0.19%, respectively. The incidence of both early and late age-related macular degeneration is higher in European ancestry than other ethnicities. Besides, gender might impact the incidence of late disease.

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries (see page 1435)

In Europe, travel distance to a retinoblastoma centre is not a barrier to early diagnosis. In Africa, most cases that present live close to treatment centres, yet present late, and those living far from centres do not present for treatment.

Vascular findings in primarily affected and fellow eyes of middle-aged patients with Coats’ disease using multimodal imaging (see page 1444)

All fellow eyes of patients with unilateral diagnosed Coats’ disease showed vascular abnormalities, including capillary bed (89%), tortuous (58%) and microaneurysmatic abnormalities (26%).

Prognostic value of TERT promoter mutations in conjunctival melanomas in addition to clinicopathological features (see page 1454)

This study reveals telomerase reverse transcriptase promotor mutations, pT status, high tumour thickness, epithelioid cells, mitoses and ulceration correlated with metastasis in conjunctival melanomas, signifying both histopathology and molecular pathology of prognostic relevance.

Human leucocyte antigen alleles confer susceptibility to and progression of Graves’ ophthalmopathy in a Southern Chinese population (see page 1462)

Alleles HLA-DRB1*16:02 and -DQB1*05:02 were common susceptibility risks for Graves' disease, and alleles HLA-B*38:02 and -DQA1*01:02 contributed to the progression of Graves’ ophthalmopathy by presenting the potential pathological antigen in a Southern Chinese population

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