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Academy Express
 
A weekly news brief from the American Academy of Ophthalmology
and the International Society of Refractive Surgery


ISRS - Academy Express
ISRS Advisory Panel: Matteo Piovella, MD, John A. Vukich, MD
Contact Information

01 July 2010 Twitter: Follow AAO Twitter: Follow ISRS

New Journal Studies

Academy News

AAO Online Community (AAO Members)


NEW JOURNAL STUDIES

Intensive glucose treatment and combination lipid therapy slows progression of diabetic retinopathy
This prospective, multi-center study randomized 10,251 participants with type 2 diabetes who were at high risk for cardiovascular disease to receive either intensive or standard treatment for glycemia (target glycated hemoglobin level, <6.0% or 7.0 to 7.9%, respectively) and also for dyslipidemia (160 mg daily of fenofibrate plus simvastatin or placebo plus simvastatin) or for systolic blood-pressure control (target, <120 or <140 mm Hg). A large subgroup was evaluated for the effects of these interventions at four years follow-up. They found that both intensive glycemic control and intensive combination treatment of dyslipidemia, but not intensive blood-pressure control, reduced the rate of progression of diabetic retinopathy by about one-third. New England Journal of Medicine, June 29, 2010

Sutureless cataract incisions can cause serious complications during subsequent vitrectomy
This retrospective study included five patients (five eyes) who suffered complications during vitrectomy surgery associated with clear corneal incisions from previous cataract surgery. In all eyes, the cataract wound leaked extensively with minimal manipulation of the sclera at the pars plana. Four eyes developed choroidal detachment associated with hypotony, three of which developed hemorrhagic choroidal detachment with subretinal and/or vitreous hemorrhage. One eye developed iris incarceration and anterior subluxation of a sulcus-placed IOL. Median final visual acuity was 20/400 (range, 20/40 to hand motions). The retina remained attached in all cases at the latest follow-up visit. Retina, June 2010

DSAEK appears safe, effective in TASS patients
This prospective study included 10 consecutive patients (10 eyes) who underwent Descemet-stripping automated endothelial keratoplasty (DSAEK) for corneal failure following toxic anterior segment syndrome (TASS). At 12 months follow-up there were no primary graft failures or graft rejection, and all grafts were clear. Visual acuity improved in all eyes by six months postop. Endothelial cell loss was 38 percent, which is comparable to other DSAEK studies of patients with corneal edema caused by etiologies other than TASS. Journal of Cataract & Refractive Surgery, June 2010

Glaucoma experts don’t agree on implications of IOP fluctuation
Researchers used a modified Delphi process to determine the degree of consensus among a multinational panel of nine glaucoma experts concerning the measurement, characterization, and potential implications of IOP and its fluctuation over time for glaucoma treatment. They found consensus on 46 percent of 81 statements, non consensus on 6 percent and indeterminate status in 48 percent. The least amount of consensus was found on statements regarding different methods/instruments to measure IOP, and the clinical implications of short-term and long-term IOP fluctuation. As a result, they recommended a unified terminology for defining IOP fluctuation. Glaucoma Journal, June 2010

OCT analysis reveals structural features of juvenile X-linked retinoschisis
Using optical coherence tomography (OCT) images to evaluate 18 patients (34 eyes) with juvenile X-linked retinoschisis they found that – despite conventional wisdom – the schisis cavity can occur in a number of different layers of the neurosensory retina (retinal nerve fiber layer, inner nuclear layer, and outer nuclear layer/outer plexiform layer). In addition, different forms of schisis may affect different locations in the macula (foveal or parafoveal). In most eyes, the schisis involves the entire foveomacular region. American Journal of Ophthalmology, June 2010

More evidence supporting link between sleep apnea and proliferative diabetic retinopathy
Researchers used a pulse oximeter to evaluate items of sleep-disordered breathing in 219 consecutive patients who had type 2 diabetes with either nonproliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR). The lowest mean oxygen saturation levels (SpO2)were significantly lower in the PDR group than in the NPDR group as were the sleeping 4% oxygen desaturation index and cumulative percent time spent at SpO2 < 90% levels. Logistic regression analysis identified being younger, having a lower value for the lowest SpO2, and a high hemoglobin A1c value to be independent risk factors for PDR. American Journal of Ophthalmology, June 2010

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ACADEMY NEWS

Secure your course tickets now; nonmember registration opens July 7 for the 2010 Joint Meeting
Popular courses, such as Breakfast With the Experts and the Skills Transfer courses are filling up now. Review all the offerings with the new and improved Program Search function, then login to purchase your courses, and keep track of your schedule with the new calendar feature.

New Academy Grand Rounds: Homeless man needs new glasses
A 52-year-old man with a history of cocaine dependency presents for spectacles after losing his previous pair, but your exam uncovers additional concerns. Diagnose the condition from the symptoms and signs and recommend an appropriate treatment strategy. This activity can be claimed for up to 1 AMA PRA Category 1 Credit.

New edition of The Profession of Ophthalmology picks up where med school left off
Fully revised to reflect recent changes, the second edition of The Profession of Ophthalmology: Practice Management, Ethics, and Advocacy explores financial management, marketing, information technology, professional development, real-life ethics practice studies and how legislation affecting the practice of ophthalmology is made. This book is available only in a downloadable format, featuring easy navigation, search, hyperlinks to references and websites, and a printable format. Visit the Academy Store for more information and to purchase.

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AAO ONLINE COMMUNITY

What’s new in the Academy online community

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Editor-in-Chief: Dr. David W. Parke II
Chief Medical Editor: Dr. Andrew G. Iwach
Managing Editor: Susanne Medeiros

AAO Advisory Panel: Drs. Terry L. Forrest, Jean E. Ramsey, Franco M. Recchia, James C. Tsai,
Eliza Hoskins, Sunita Radhakrishnan

CONTACT INFORMATION
International Society of Refractive Surgery
aeisrsaao@aao.org


The Academy provides the items appearing in the Academy Express as a service. The articles and studies come from news reports and peer-reviewed journals, and are not the product, opinion or position of the Academy unless explicitly stated to be so. The Academy does not endorse products, companies or organizations. The Academy disclaims all liability. If you would like to update your e-mail address or be removed from the mailing list, please send a request to ISRS.

©2010 American Academy of Ophthalmology. All rights reserved.


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