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

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Accurate detection and grading of pterygium through smartphone by a fusion training model (see page 336)

The authors' fusion model method works as a helpful tool for improving pterygium detection and grading accuracy in the context of insufficient smartphone data in the absence of a mobile mature database.

Collagen type XII is undetectable in keratoconus Bowman’s layer (see page 343)

Collagen type XII, a regulator of corneal form and stability, is undetectable in Bowman’s layer of keratoconic corneas, suggesting a possible integral role in the pathogenesis of keratoconus.

Differentiating stages of functional vision loss from glaucoma using the disc damage likelihood scale and cup/disc ratio (see page 349)

Disc damage likelihood scale (DDLS) and cup/disc ratio distinguished early/moderate/advanced from severe/end-stage glaucoma. DDLS achieved a significant larger area under the receiver-operating curve. Both techniques are important for planning the management of late-stage glaucoma.

Influence of choroidal microvasculature dropout on progressive retinal nerve fibre layer thinning in primary open-angle glaucoma: comparison of parapapillary β-zones and γ-zones (see page 357)

Presence of parapapillary choroidal microvasculature dropout was a predictive factor for faster RNFL thinning when it was observed within the parapapillary β-zones, but not γ-zones.

Iris volume change with physiologic mydriasis to identify development of angle closure: the Zhongshan angle closure prevention trial (see page 366)

This prospective assessment demonstrates that lower loss of iris volume with physiologic pupil dilation is an additive risk factor for angle closure disease progression.

Central visual field damage in glaucoma eyes with choroidal microvasculature dropout, with and without high axial myopia (see page 372)

In this cross-sectional study, choroidal microvasculature dropout was more prevalent in glaucomatous eyes with high axial myopia compared with those without high axial myopia. However, choroidal microvasculature dropout was associated with more severe disease and central visual field damage regardless of myopia status.

Long-term visual acuity outcomes following cataract surgery in eyes with ocular inflammatory disease (see page 380)

Adult and paediatric eyes with uveitis benefit from sustained improved visual outcome for several years after surgery. Paediatric age group, pre-operative active inflammation and aphakia are associated with poor outcomes.

Assessment of choriocapillaris and choroidal vascular changes in posterior uveitis using swept-source wide-field optical coherence tomography angiography (see page 386)

In posterior uveitis, the mean perfusion density in the OCTA choriocapillaris scans was significantly lower than healthy controls. The metrics of choroidal slabs may be useful to assess disease activity in uveitis.

The incidence and multimodal imaging characteristics of macular neovascularisation subtypes in Chinese neovascular age-related macular degeneration patients (see page 391)

The authors report the incidence of macular neovascularisation (MNV) subtypes in Chinese neovascular age-related macular degeneration (nAMD) patients based on anatomical classification and revealed the findings in specific forms of polypoidal choroidal vasculopathy (PCV).

Acute posterior multifocal placoid pigment epitheliopathy: clinical presentation and risk of stroke and transient ischaemic attack (see page 398)

Stroke/TIA occurred in 11.7% of subjects with APMPPE. The only significant risk factor for stroke/TIA was older age at presentation. Headache was not a significant risk factor for stroke/TIA.

Sympathetic nervous system activity is associated with choroidal thickness and axial length in school-aged children (see page 405)

An elevated level of sympathetic nervous system activity due to chronic environmental stress, is associated with significant increase in the axial length elongation, probably through the thinning of the choroid in school-aged children.

Pathologic myopia in highly myopic patients with high axial anisomyopia (see page 411)

In patients with high myopia and high axial anisometropia, complications of pathological myopia in the longer eye predict similar complications in the shorter eye, despite axial lengths that may suggest otherwise. Close monitoring is suggested.

Ensemble of deep convolutional neural networks is more accurate and reliable than board-certified ophthalmologists at detecting multiple diseases in retinal fundus photographs (see page 417)

An ensemble of deep convolutional neural networks is more accurate and reliable than seven board-certified ophthalmologists at overall detection of diabetic retinopathy, glaucoma, age-related macular degeneration and healthy eyes from retinal fundus photographs.

Application of artificial intelligence system for screening multiple fundus diseases in Chinese primary healthcare settings: a real-world, multicenter and cross-sectional study of 4795 cases (see page 424)

This study may be the first to demonstrate the dependability of the AI system for detecting multiple retinal diseases in primary healthcare settings and investigating the spectrum of fundus diseases at community level between two areas with significant income disparities.

Deep segmentation of OCTA for evaluation and association of changes of retinal microvasculature with Alzheimer’s disease and mild cognitive impairment (see page 432)

The authors propose a standardised framework for automated analysis of OCTA images. They demonstrate its suitability by investigating the microvascular and foveal avascular zone alterations in and between Alzheimer’s Disease and Mild Cognitive Impairment and healthy controls.

Randomised controlled trial of adjunctive triamcinolone acetonide in eyes undergoing vitreoretinal surgery following open globe trauma: the ascot study (see page 440)

In this randomised controlled trial of 280 patients, the addition of triamcinolone at the time of vitrectomy following open globe trauma did not improve visual outcomes.

Correlating somatic copy number alteration in aqueous humour cfDNA with chemotherapy history, eye salvage and pathological features in retinoblastoma (see page 449)

Biopsy of aqueous humour in retinoblastoma showed that 2p gain and 7q gain were more commonly detected in primary enucleation eyes than those with previous chemotherapy. Loss of 19q was associated with massive choroidal invasion and post-laminar invasion of optic nerve.

Impact of tumour volume and treatment delay on the outcome after linear accelerator-based fractionated stereotactic radiosurgery of uveal melanoma (see page 457)

The tumour volume described in millilitres, rather than treatment delay, is the most robust prognostic factor for treatment outcome in uveal melanoma. Tumour volume should be integrated into the staging system of uveal melanoma, and rapid access to treatment of uveal melanoma is mandatory.

Orbital and periocular complications in patients with sinonasal tumours with orbital invasion (see page 465)

Eye-sparing approaches for patients with sinonasal tumours and secondary orbital invasion can lead to reasonably good functional outcome and are worth pursuing, despite expected orbital and periocular complications.

Validation of the East London retinopathy of prematurity algorithm to detect treatment-warranted retinopathy of prematurity: a cohort study (see page 471)

The EL-ROP screening criteria correctly predicted treatment-warranted ROP and demonstrated superior specificity in comparison to standard ROP screening criteria, thereby reducing the number of premature infants undergoing examinations and reducing the burden of ROP screening in the UK.

Incidence of and risk factors for glaucoma and suspected glaucoma development after bilateral congenital cataract surgery: a five-year follow-up study (see page 476)

Increased incidence of glaucoma and suspected glaucoma was identified in long-term follow-up after congenital cataract surgery. Eyes with microcornea and congenital cataract family history were risk factors for glaucoma and suspected glaucoma.

Self-reported dual sensory impairment and related factors: a European population-based cross-sectional survey (see page 484)

This European population-based cross-sectional survey including 153 866 respondents, aged 50 years or more, reports an age-adjusted prevalence of dual vision and hearing loss of 7.73% [7.55 to 7.91].

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  • Contributors N/A.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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