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In the United Kingdom, a national diabetic retinopathy screening service has pioneered the use of remote monitoring of disease at a population level. Glaucoma has persistently frustrated clinicians and those who have tried to apply a similar model of diagnosis and monitoring. In this month's issue Strouthidis et al1 discuss the barriers to remote diagnosis of glaucoma and review the future prospects for telemedicine in this area.
There are a number of grading systems of clinically significant diabetic macular oedema. Bolz et al2 describe a new grading protocol based on a combination of OCT and fluorescein angiographic findings. In a study of 40 patients, they report interobserver variability for each component of their grading system.
Melanoma is one of the few conditions in ophthalmology with the potential to kill. Van Essen et al3 in a study of 30 enucleation specimens of uveal melanoma report loss of BAP1 expression as a predictor of death from metastases. Yin et al4 in a study of 64 patients with eyelid melanoma that almost 40% of patients required more than one surgical excision supporting the argument for delayed surgical reconstruction for eyelid melanoma.
Myopia is an increasingly common condition and the pathogenetic changes remain poorly understood. Nagra et al5 emphasize the likely importance of ocular volume rather than axial length and in a study of total ocular volume from MRI scans of 67 adults they observed axial length and corneal radius to predict ocular volume. The authors postulate that ocular volume rather than axial length might be a structural correlate for IOP elevation after invitreal injection.
Dry eye disease appears to be increasingly common. Vehof et al6 found in a population-based cross-sectional association study of 3824 female twin volunteers aged 20–87 years that in response to a questionnaire, 9.6% reported a diagnosis of dry eye disease and reported a number of risk factors. Submandibular gland transplantation offers some hope for patients with severe dry eye disease. Su et al7 report obstructive sialadenitis in a small proportion of 161 patients with keratoconjunctivitis sicca who underwent transplantation.
Meibomian gland disease is common in everyone's practice. Bilkhu et al8 report a subjective benefit in the Eyebag treatment for meibomian gland disease lasting at least 6 months in a randomised clinical trial of 25 patients.
Tuberculosis uveitis remains difficult to diagnose. Ang et al9 in a prospective study of 102 consecutive new paitents report discordant results from Interferon gamma release assays and tuberculin skin tests in patients with uveitis.
We hope you enjoy this month's issue.