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

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Treatment strategies and long-term outcomes in patients with congenital microphthalmia-anophthalmia with cyst (see page 750)

Cysts associated with micropthalmia-anophthalmia can be detrimental to the long-term cosmetic rehabilitation of these patients. Timely decision-making regarding prosthesis fitting, cyst excision and orbital volume replacement is vital for a favourable outcome.

Diffuse pattern, orbital invasion, perineural invasion and Ki-67 positivity are associated with nodal metastasis in patients with eyelid sebaceous carcinoma (see page 756)

Diffuse pattern, orbital invasion, perineural invasion and high Ki-67 percentage positivity were identified as independent risk factors for nodal metastasis of eyelid sebaceous carcinoma. A nomogram based on these risk factors was established to provide individualised estimates.

Possible association between viral infection and short survival of the corneal graft after penetrating keratoplasty in patients with congenital corneal opacity: a cohort study (see page 763)

Viral DNA can be detected in the excised corneal tissue of patients with congenital corneal opacities. It may be associated with poor graft survival after PK but may point to aetiology of congenital corneal opacity in a proportion of cases.

Multidrug-resistant keratitis: challenging yet manageable (see page 769)

Gram-negative bacilli were found to be the the most common organism associated with multidrug-resistant keratitis. The response to the treatment was better if appropriate treatment started early.

Novel ADAMTSL4 gene mutations in Chinese patients with isolated ectopia lentis (see page 774)

Five isolated ectopia lentis probands with eight novel mutations in the ADAMTSL4 gene were detected. Cataract is an early and common complication. The frequency of ADAMTSL4 mutations in congenital ectopia lentis patients is 3.9%.

Changing operating room practices: the effect on postoperative endophthalmitis rates following cataract surgery (see page 780)

The results of a retrospective sequential clinical registry study at the Aravind Eye Care System, looking at over 85 000 patients undergoing cataract surgery before and during the COVID lock-down, suggests that patients wearing gowns, surgeons changing gloves between patients, room cleaning after each patient, and having only one patient in a room had no significant effect on postoperative endophthalmitis. This study suggests that we should re-evaluate and challenge common practices, and re-evaluate unnecessary guidelines and empiric practices.

Uveal lymphoid hyperplasia: treatment with combination antibiotics and steroids (see page 786)

Combination antibiotic/steroid therapy is a reasonable treatment for select cases of uveal lymphoid hyperplasia.

Impact of the COVID-19 pandemic on uveitis patient care (see page 790)

The coronavirus pandemic has changed practice of uveitis worldwide. Uveitis patient care and recommendations on immunosuppression and vaccination will continue to evolve as new data become available.

Optimal number and orientation of anterior segment OCT images to measure ocular biometric parameters in angle closure eyes: the Chinese American Eye Study (see page 795)

A single OCT image along the nasal-temporal meridian does not accurately reflect sectoral variations of anterior segment anatomy. A multi-image approach with a starting meridian offset from the horizontal provides a more accurate alternative.

Reproducibility of deep learning based scleral Spur localisation and anterior chamber angle measurements from anterior segment optical coherence tomography images (see page 802)

A deep learning method was applied to automatically locate the scleral spur in the AS-OCT images. Repeatability of anterior chamber angle measurements was comparable with manual plotting of the scleral spur.

Relationship of macular ganglion cell complex thickness to choroidal microvasculature dropout in primary open angle glaucoma (see page 809)

In this observational cohort study, glaucomatous eyes with deep-layer microvascular dropout (MvD) exhibited faster ganglion cell complex thinning than those without MvD.

Relationship between macular intercapillary area measured by optical coherence tomography angiography and central visual field sensitivity in normal tension glaucoma (see page 816)

Enlargement of macular intercapillary area was associated with decreased ganglion cell-inner plexiform layer thickness and central visual field sensitivity in early normal tension glaucoma eyes, but not in moderate-to-severe NTG and normal control eyes.

Intraocular pressure and diurnal fluctuation of open-angle glaucoma and ocular hypertension: a baseline report from the LiGHT China trial cohort (see page 823)

This paper presents the baseline intraocular pressure of LiGHT China Trial, which aimed to evaluate whether selective laser trabeculoplasty, as a first-line treatment, provides superior economic and health-related quality of life outcomes to medical treatment in China.

Serum complement component 3, complement component 4, and complement component 1q levels predict progressive visual field loss in older women with primary angle closure glaucoma (see page 828)

This large sample (n = 308) prospective cohort study suggested that complement system may play a significant role in the visual field loss progression in older women with primary angle closure glaucoma.

Choriocapillaris perfusion assessed using swept source optical coherence tomographic angiography and the severity of diabetic retinopathy (see page 836)

This cross-sectional study of a large sample of Chinese diabetic patients demonstrated that the choriocapillaris flow deficit density, number, and size using SS-OCTA reflecting CC flow impairment independently correlated with the severity of DR. This suggests the potential of choriocapillaris changes in DR pathogenesis.

Hemiretinal vein occlusion 12-month outcomes are unique with vascular endothelial growth factor inhibitors. Data from the Fight Retinal Blindness! Registry (see page 842)

Hemi-retinal vein occlusions start with vision and macular thickness similar to central vein occlusion but end like branch occlusion variants with vascular endothelial growth factor inhibitor treatment. Inclusion of hemi-retinal occlusion patients in clinical trials could introduce bias.

Quantitative analysis of optical coherence tomography imaging in patients with different severities of hydroxychloroquine toxicity (see page 849)

In this analysis of patients with long term hydroxychloroquine use, eyes with even mild toxicity could be distinguished from eyes without toxicity using OCT outer retinal thickness and intensity-based measures. Differences from unaffected eyes increased with increasing toxicity severity.

Risk factors for epiretinal membrane in eyes with primary rhegmatogenous retinal detachment that received silicone oil tamponade (see page 856)

Among eyes with primary rhegmatogenous RD that received silicone oil tamponade, 12.3% exhibited ERM. The main risk factors for ERM in eyes with SO tamponade were preoperative PVR, type 2 diabetes, photocoagulation energy, and SO tamponade duration.

Higher-order aberrations and their association with axial elongation in highly myopic children and adolescents (see page 862)

Ocular horizontal comatic aberration, besides spherical aberrations, were negatively associated with axial elongation in children and adolescents with high myopia, and not found in those with moderate myopia.

Association of progressive optic disc tilt with development of retinal nerve fiber layer defect in children with large cup-to-disc ratio (see page 869)

In Korean children with a large cup-to-disc ratio and no other glaucomatous findings, progressive optic disc tilt during myopia progression was associated with higher risk of developing retinal nerve fibre layer defect.

Prevalence of blindness and distance vision impairment in the Gambia across three decades of eye health programming (see page 876)

A national eye health survey in the Gambia in 2019 found the prevalence of blindness in adults 35+ was 1.2%; a relative reduction of 40% since 1996 following two decades of eye health programme implementation.

National trends in surgical subspecialisation in ophthalmology in the United States (see page 883)

In the US, some ophthalmic surgeons narrow their surgical practice to subspecialty procedures and rarely perform core domain surgeries, suggesting a trend towards surgical subspecialisation.

Scleral growth stunting via sub-tenon injection of cross-linking solutions in live rabbits (see page 889)

The application of topical cross-linking solutions containing formaldehyde releasers via sub-Tenon’s injection in live rabbits is described. The results indicate that axial growth stunting of the rabbit globe can be achieved without clinical side-effects.

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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