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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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Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared to observation alone (see page 1196)

In this population-based birth cohort of 1958 infants with congenital nasolacrimal duct obstruction, patients prescribed topical antibiotics or digital massage, individually or in combination, had a higher rate of resolution than observation alone.

Prevalence and risk factors for chalazion in an older veteran population (see page 1200)

6.04% of individuals (208,720/3,453,944) were diagnosed with chalazion during the study period. The majority of these cases occurred in coastal regions. The strongest risk factors for chalazion included ocular surface, eyelid, and periocular disorders.

Predictors of progression in untreated keratoconus: a save sight keratoconus registry study (see page 1206)

This real-world study has found age and Kmax to be the most useful predictors of progression of unmodified keratoconus as they are associated with worsening of two clinical parameters.

Role of anterior segment optical coherence tomography angiography in assessing limbal vasculature in acute chemical injury of the eye (see page 1212)

Anterior segment optical coherence tomography was able to provide non-contact, rapid assessment of limbal vasculature in acute chemical injury, which may provide an objective assessment compared to subjective slit-lamp examination.

Ocular manifestations of congenital insensitivity to pain: a long-term follow-up (see page 1217)

We describe ocular complications of congenital insensitivity to pain, an inherited condition associated with impaired corneal sensation. Early recognition of this condition and close follow-up may prevent corneal opacities and vision loss in these patients.

AI-powered effective lens position prediction improves the accuracy of existing lens formulas (see page 1222)

Integrating machine learning-powered intraocular lens position estimation with traditional effective lens position (ELP) calculation improves the postoperative refraction prediction accuracy of four existing formulas.

A nationwide multicentre comparison of preoperative biometry and predictability of cataract surgery in Japan (see page 1227)

In our nationwide multicentre study, there were significant regional variations in most preoperative biometric parameters, and the optimised intraocular lens power calculation formula was different among all surgical facilities, even in a single country.

Clinical outcomes following selective laser trabeculoplasty in Afro-caribbean glaucoma patients at high risk for progression (see page 1235)

When patient-specific treatment goals are considered, selective laser trabeculoplasty performed in Afro-Caribbeans with medically-treated open-angle glaucoma significantly reduces IOP in patients seeking IOP reduction and significantly reduces the medication burden in patients seeking medication reduction.

Polymorphisms of the cytomegalovirus glycoprotein B genotype in patients with Posner-Schlossman syndrome (see page 1240)

The results of this study showed that cytomegalovirus gB genotype 1 is predominant in the aqueous humour of patients with Posner-Schlossman syndrome, whereas bilateral attack is predominant in those infected with gB genotype 3.

Association of foveal avascular zone area with structual and functional progression in glaucoma patients (see page 1245)

A larger foveal avascular zone is associated with higher risk of RNFL and GC-IPL thinning. OCTA metrics are more closely associated with structural changes rather than functional changes of glaucoma.

Glaucoma diagnostic capabilities of macular vessel density on optical coherence tomography angiography: superficial versus deep layers (see page 1252)

Superficial macular vessel density had significantly better glaucoma discrimination ability and higher association with central visual field sensitivity than deep macular vessel density in open-angle glaucoma eyes.

Association of macular and choroidal perfusion with long-term visual outcomes after macula-off rhegmatogenous retinal detachment (see page 1258)

After surgical repair of macula-involving retinal detachment, eyes with denser superficial vessel density, lower number of choriocapillaris flow deficits, and the larger average size of choriocapillaris flow deficits were associated with better vision. This highlights the potential of the OCTA to study the pathophysiological mechanism related to retinal detachment involving the macula.

Incidence and progression of diabetic retinopathy in a multi-ethnic US cohort: the multi-ethnic study of atherosclerosis (see page 1264)

This prospective multi-ethnic population-based study suggests that about one in five persons with diabetes developed diabetic retinopathy, while almost a quarter showed regression in retinopathy over an 8 year period in the United States.

North Carolina macular dystrophy shows a particular drusen phenotype and atrophy progression (see page 1269)

A specific phenotype and distribution of drusen is associated with North Carolina Macular Dystrophy, and macular atrophy may enlarge over time. A rare variant upstream of PRDM13 is a common cause in central Europe.

Novel disease-causing variant in RDH12 presenting with autosomal dominant retinitis pigmentosa (see page 1274)

A novel RDH12 variant, c.763delG revealed as a cause of autosomal dominant rod-cone dystrophy with variable phenotypic expression in a four-generation pedigree. Adaptive optics imaging identified an individual with incomplete penetrance as clinically affected.

Characterisation of macular neovascularisation in geographic atrophy (see page 1282)

In this study reporting features of macular neovascularisation in geographic atrophy (GA), we proposed that combined phenotype (ie, GA with neovascular AMD) should be considered as a distinct entity in the research and clinical setting.

Short-Term real-world outcomes following intravitreal brolucizumab for neovascular AMD: SHIFT-study (see page 1288)

In a real-world setting, structural parameter analysis following switch in anti-VEGF therapy to brolucizumab showed overall favourable efficacy in patients with neovascular age-related macular degeneration.

Systemic conbercept pharmacokinetics and VEGF pharmacodynamics following intravitreal injections of conbercept in patients with retinopathy of prematurity (see page 1295)

VEGF levels at 1 week were suppressed following intravitreal injections of conbercept in retinopathy of prematurity due to the leakage of the drug into the systemic circulation. Levels returned to baseline at 4 weeks.

Computer-Aided detection (Cade) and abnormality score for the outer retinal layer in optical coherence tomography (see page 1301)

We aimed to develop computer-aided detection (CADe) of outer retinal layer (ORL) abnormalities via optical coherence tomography (OCT). The results of CADe use highlighted aspects of visualisation of the ORL and our binary classifier demonstrated excellent performance.

Retinal microvascular signs in COVID-19 (see page 1308)

Among COVID-19 positive young adult men with no medical history, one in nine had retinal microvascular signs on ocular imaging, which could be related to underlying cardiovascular and thrombotic alterations in COVID-19 infection.

Detection of SARS-CoV-2 genomic and subgenomic RNA in retina and optic nerve of COVID-19 patients (see page 1313)

SARS-CoV-2 genomic and subgenomic RNA were detected in post-mortem retinal and optic nerve tissue samples. Virus isolation failed and no SARS-CoV-2 spike protein could be detected in immunohistochemistry.

An evaluation of treatment response and symptom progression in four hundred patients with visual snow syndrome (see page 1318)

This study represents a comprehensive evaluation of treatment response in visual snow syndrome. It also confirms, through the use of a clinical diary, that the condition is extremely stable over time.

Distribution and associations of vision-related quality of life (VQoL) and functional vision (Fv) of children with visual impairment (see page 1325)

Self-rated vision-related quality of life of visually impaired children cannot be predicted using clinical characteristics. Self-rated functional vision complements clinical assessments. This study provides a reference for future interpretation of VQoL CYP and FVQ CYP scores.

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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