Ophthalmologica Update: The Peer-reviewed Journal Of Euretina Edited By Sebastian Woolf

AREDS IN REVIEW The current issue of Ophthalmologica includes the text of the Kreissig lecture delivered by Emily Chew MD at the 16th Congress of EURETINA. In a wide-ranging discussion, she reviewed the evidence from the Age-Related Eye Disease Study (AREDS) and AREDS2 trials, which showed that supplementation with antioxidant vitamins and minerals can significantly slow the progression of the disease age-related macular degeneration (AMD). The AREDS2 data showed that lutein and zeaxanthin are an effective alternative to the beta-carotene and, unlike beta-carotene, are safe for smokers and former smokers. The AREDS2 results also showed that omega-3 long-chain polyunsaturated fatty acids had no beneficial effect on AMD. Dr Chew adds that, as yet, genetic testing prior to administering AREDS supplements has not proved clinically useful. E Chew, “Nutrition, Genes, and Age-Related Macular Degeneration: What Have We Learned from the Trials”, Ophthalmologica 2017, Volume 238, Issue 1-2. DIFFERENT MORPHOLOGY for HIGH-RISK CARRIERS Early-stage AMD patients who are homozygous for the CFH gene and/or the ARMS 2 gene appear to have different disease characteristics than those without the genes. Among 85 patients with early AMD, spectral domain optical coherence tomography (SD-OCT) showed lower retinal thickness in patients homozygous for CFH or ARMS2. The reduced thickness was caused by a significantly reduced photoreceptor layer, which corresponded to reduced retinal sensitivity detected with microperimetry. The number and ultrastructure of drusen also differed significantly between the groups. M Oeverhaus et al, “Genetic Polymorphisms and the Phenotypic Characterization of Individuals with Early Age-Related Macular Degeneration”, Ophthalmologica 2017, Volume 238, Issue 1-2. PORTABLE FUNDUS CAMERA PROVIDES 
GOOD-QUALITY IMAGES A new study suggests that well trained paraprofessional health care staff can obtain high-quality images with a portable non-mydriatic fundus camera. The study compared the quality of mydriatic and non-mydriatic fundus images taken with a Smartscope camera (Optomed) with that of mydriatic fundus images taken with a Topcon tabletop fundus camera (Topcon). Two retina specialists graded a total of 2,475 images obtained from 275 eyes of 155 participants. They found that they could reliably grade 76.2% of the Smartscope non-mydriatic images, 90.1% of the Smartscope mydriatic images and 92.0% of the Topcon mydriatic images. Excluding eyes with cataract or vitreous haemorrhage, the proportion of non-mydriatic macular images they could grade improved to 94.6%. J R Davila et al, “Predictors of Photographic Quality with a Handheld Nonmydriatic Fundus Camera Used for Screening of Vision-Threatening Diabetic Retinopathy”, Ophthalmologica 2017 Volume 238, Issue 1-2.

Tags: Ophthalmologica