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

Volume 238, Issue 1-2.

Sebastian Wolf

Posted: Friday, September 1, 2017

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.