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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 NHS Foundation Trust, London, UK; dfplarkin{at}

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Eye health indicators for universal health coverage: results of a global expert prioritisation process (see page 893)

An online prioritisation process among 72 eye health experts from all global regions produced a menu of 22 indicators which can inform new national eye health monitoring frameworks and countries’ progress towards universal health coverage.

Use of saliva flow rate measurement in minor salivary glands autotransplantation for treatment of severe dry eye disease (see page 902)

The saliva flow rate of the minor salivary glands was measured before minor salivary gland transplantation for the treatment of the dry eye disease. Patients whose donors had a higher saliva flow rate were found to have better surgical results.

Anterior segment reconstruction with artificial iris and Descemet membrane endothelial keratoplasty: a staged surgical approach (see page 908)

A staged approach of anterior segment reconstruction with an artificial iris implant followed by Descemet membrane endothelial keratoplasty in complex eyes with corneal decompensation is a safe and feasible approach for restore the anterior segment and corneal clarity.

Cost-effectiveness analysis of preloaded versus non-preloaded Descemet membrane endothelial keratoplasty for the treatment of Fuchs endothelial corneal dystrophy in an academic centre (see page 914)

Preloaded grafts in Descemet membrane endothelial keratoplasty was cost-effective and cost-saving relative to non-preloaded grafts, being less costly while generating comparable QALYs from a healthcare perspective.

Economic, clinical and social impact of simple limbal epithelial transplantation for limbal stem cell deficiency (see page 923)

A comprehensive literature survey, questionnaire-based survey and economic analysis indicates that simple limbal epithelial transplantation is a better alternative to cultivated limbal epithelial transplantation in terms of anatomical success, cost and accessibility.

Time to achieve best post-operative visual acuity following Boston keratoprosthesis surgery (see page 929)

Time to best corrected visual acuity was 3 to 6 months postoperatively for most patients who underwent Boston type one keratoprosthesis surgery. New-onset postoperative glaucoma, retroprosthetic membrane and endophthalmitis significantly prolonged this time duration.

Long-term outcomes following primary versus secondary Boston keratoprosthesis type 1 implantation (see page 935)

A retrospective cohort study of 82 eyes comparing primary and secondary Boston keratoprosthesis implantation showed favourable long-term vision post primary implantation, but less device retention and more glaucoma, idiopathic vitritis, and choroidal detachment.

Review of de novo uveitis in older adults presenting to a large tertiary centre (see page 941)

De novo uveitis in the older population accounts for 23.4% of all subjects with uveitis. Lymphoma is an uncommon cause found in 1.9% of subjects, but represented 11.2% of intermediate uveitis.

Avoiding mask-related artefacts in visual field tests during the COVID-19 pandemic (see page 947)

Unfitted masks can simulate VF progression in around 6% of cases, mainly in the inferior hemifield, and increase significantly the rate of fixation losses.

Normal-tension glaucoma is associated with cognitive impairment (see page 952)

Normal-tension glaucoma was associated with impaired cognition in a cross-sectional screening study of 597 high-tension and normal-tension glaucoma participants randomly sampled from the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG).

Changing trends in glaucoma surgery within Australia (see page 957)

There has been a significant increase in rates of glaucoma drainage device insertion within Australia between 2001–2018 as compared with a gradual decline in age- and gender-standardised numbers of trabeculectomy surgery over the same time.

Utilisation of poor-quality optical coherence tomography scans: adjustment algorithm from the Singapore epidemiology of eye diseases (seed) study (see page 962)

We developed an algorithm that can optimise OCT parameters at lower to higher signal strengths. This algorithm can allow utilisation of poor-quality OCT scans that are usually discarded. The results of this algorithm may help in glaucoma diagnosis and monitoring in patients in whom it is difficult to obtain good quality scans.

Low fraction of fetal hemoglobin is associated with retinopathy of prematurity in the very preterm infant (see page 970)

In this study, we investigated the association between early postnatal fraction of fetal haemoglobin and the development of ROP in 452 consecutively born very pre-term infants. Low fraction of HbF during the first postnatal week emerged as a strong independent predictor of ROP. Minimising blood loss and transfusions of adult blood components, thus maintaining a higher fraction of HbF, may prevent ROP.

Comparison of clinical outcomes of conbercept versus ranibizumab treatment for retinopathy of prematurity: a multi-central prospective randomized controlled trial (see page 975)

We compared the recurrence rate and complications of retinopathy of prematurity after the treatment for conbercept vs ranibizumab within 6 months. A multi-central prospective randomised controlled trial. Both agents were shown to be effective.

Association between body mass index and diabetic retinopathy in Asians: the Asian eye epidemiology Consortium (AEEC) study (see page 980)

In a pooled analysis including 10 010 Asian adults with diabetes from 12 cross-sectional studies across six Asian countries, obesity was inversely associated with both any diabetic retinopathy and vision-threatening diabetic retinopathy, independent of potential risk factors.

Efficacy of a novel personalised aflibercept monotherapy regimen based on polypoidal lesion closure in participants with polypoidal choroidal vasculopathy (see page 987)

We report the results of a novel personalised anti-vascular endothelial growth factor monotherapy regimen for the management of polypoidal choroidal vasculopathy which achieves comparable outcomes to a fixed 8-weekly regimen and high polypoidal lesion closure rate.

Efficacy and safety of brolucizumab versus aflibercept in eyes with polypoidal choroidal vasculopathy in Japanese participants of hawk (see page 994)

Visual outcomes were comparable and anatomical outcomes were favourable in eyes with PCV treated with brolucizumab (12-/8-weekly) compared with those treated with 8-weekly aflibercept. Most brolucizumab-treated eyes were maintained on a 12-weekly interval over 96 weeks.

Postoperative outcomes of idiopathic epiretinal membrane associated with foveoschisis (see page 1000)

Of 544 eyes operated for primary epiretinal membrane, 3.1% had foveoschisis. In 76% of eyes, the foveoschisis resolved postoperatively. It was associated with a higher incidence of acute postoperative macular oedema (24%).

Somatic GNAQ R183Q mutation is located within the sclera and episclera in patients with Sturge-Weber syndrome (see page 1006)

The GNAQ R183Q (c.548G>A) mutation was detected in scleral tissue in 100% of seven patients of the Sturge-Weber syndrome.

Enrichment of IGF-1R and PPAR gamma signaling pathways in orbital inflammatory diseases: steps toward understanding pathogenesis (see page 1012)

A similar network of signalling pathways, namely IGF-1R, PPAR gamma, adipocytokine and AMPK are involved in orbital inflammatory diseases. GPA, sarcoidosis and NSOI in addition to TAO may benefit from blockade of the IGF-1R signalling pathways.

Wnt signalling inhibits adipogenesis in orbital fibroblasts from patients with Graves orbitopathy (see page 1019)

Wnt signalling activation negatively modulates adipogenesis in Graves’ orbitopathy (GO). Molecular manipulation of Wnt signalling might provide an option for GO treatment.

The effect of valproic acid on functional bleb morphology in a rabbit model of minimally invasive surgery (see page 1028)

Valproic acid promotes bleb features characteristic of good surgical outcomes and modulates the organisation and content of scar proteins in a rabbit model of minimally invasive glaucoma surgery.

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  • Contributors -

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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