High Rates of Eye Surgery Cancellation in Veterans Related to Mental Health.

Introduction: Approximately 9 million veterans receive health care at the Veterans Health Administration, many of whom have psychiatric illnesses. The military continues to have higher rates of psychiatric illness compared to the civilian population. Having a diagnosis such as posttraumatic stress disorder or depression may create challenges in using health care services, such as surgery.

Comparison between Medical Student Educators and Program Directors in 2010 and 2019.

 Over the last decade, prominence of the Directors of Medical Student Education in Ophthalmology (DMSEs) within the Association of University Professors of Ophthalmology (AUPO) has increased. With increased recognition of this important leadership position, an examination of the trending demographic differences between DMSEs and the Ophthalmology Program Directors (PDs) may be helpful, especially in regard to the potential for academic promotion from each track.  Present study is a database study.

Current Scope of Online Ophthalmology Education and Curriculum Impact Due to COVID-19.

 Abrupt changes in ophthalmology education caused by the COVID-19 pandemic have resulted in novel online curriculum development. The aims of this study were to identify (1) the scope of online curricula implemented both prior to and during the COVID-19 pandemic; (2) perception of educators on these online modalities; and (3) early lessons from online implementation that may guide future curricular planning.  Implementation of online curricula was evaluated by using a national online survey of Ophthalmology Directors of Medical Student Education (DMSE) via Qualtrics software.

Clinical manifestations of intravitreal bortezomib injection.

Purpose: To describe the clinical presentation and ocular manifestations of intravitreal bortezomib.

Observations: Retrospective chart review of five patients who inadvertently received intravitreal injection of bortezomib, instead of bevacizumab, showed that all patients presented hyperacutely within 24-72 hours of the injection with pain and severe vision loss. Examination revealed a fibrinous anterior uveitis, corneal edema, and choroidal effusion associated with a shallow anterior chamber and secondary angle closure glaucoma.

Adduction-Induced Strain on the Optic Nerve in Primary Open Angle Glaucoma at Normal Intraocular Pressure.

Purpose/aim: The optic nerve (ON) becomes taut during adduction beyond ~26° in healthy people and patients with primary open angle glaucoma (POAG), but only retracts the globe in POAG. We used magnetic resonance imaging (MRI) to investigate this difference.

Materials And Methods: MRI was obtained in 2-mm quasi-coronal planes in central gaze, and smaller (~23-25°) and larger (~30-31°) adduction and abduction in 21 controls and 12 POAG subjects whose intraocular pressure never exceeded 21 mmHg.

Strabismus After Ahmed Glaucoma Valve Implantation.

Purpose: Most reports of strabismus after glaucoma drainage device implantation study larger devices and rarely note the incidence of strabismus after Ahmed glaucoma valve (AGV) implantation. It is unknown if the pattern of strabismus is similar with smaller devices. We investigated characteristics of strabismus after AGV implantation.

American Glaucoma Society Position Paper: Microinvasive Glaucoma Surgery.

In 2018, the American Glaucoma Society (AGS), the world’s largest professional society of glaucoma subspecialists, convened a 12-member task force of experts to craft a position statement about microinvasive glaucoma surgery (MIGS). The main objective of this position statement is to provide a succinct overview of these procedures and to address some misconceptions about MIGS. The members of the task force were selected by the AGS Board of Directors and include AGS members with expertise in developing MIGS, teaching MIGS, performing research on use and outcomes of these procedures, and working with the United States Food and Drug Administration (FDA) and other regulatory agencies about developing criteria to evaluate the efficacy and safety of these devices.

Efficacy of Combined Suprachoroidal Stent and Cataract Surgery in Patients With Glaucoma.

Purpose: The purpose of this study was to evaluate the efficacy of intraocular pressure (IOP) control after combined CyPass Micro-Stent implantation and cataract surgery (combined surgery).

Methods: All cases of combined surgery performed from February 2017 to July 2018 at Stein and Doheny Eye Institutes were reviewed. The primary outcome was a qualified success with stratified IOP targets based on criteria: final IOP (A) ≤18 mm Hg and reduction of 20%, (B) ≤15 mm Hg and reduction of 25%, (C) ≤12 mm Hg and reduction of 30%.

Orbital Fat Volume After Treatment with Topical Prostaglandin Agonists.

Purpose: Topical prostaglandin analogs (PGAs) are common treatment for primary open-angle glaucoma (POAG) but reportedly may cause adnexal fat atrophy. We asked if patients with POAG treated with PGAs have abnormalities in orbital fat volume (OFV).

Methods: We studied 23 subjects with POAG who had never experienced intraocular pressure (IOP) exceeding 21 mm Hg and were treated long term with PGAs, in comparison with 21 age-matched controls.

Optic Nerve Traction During Adduction in Open Angle Glaucoma with Normal versus Elevated Intraocular Pressure.

: We used magnetic resonance imaging (MRI) to investigate effects of intraocular pressure (IOP), race, and other factors on optic nerve (ON) traction in adduction, a phenomenon proposed as neuropathic in open angle glaucoma (OAG).: Thirty-five patients with OAG (26 with maximal untreated IOP ≤21 mmHg, 9 with IOP >21mmHg) and 48 controls underwent axial and quasi-coronal MRI in central gaze and large (27-33°) abduction and adduction. Some underwent MRI at smaller ductions (21-28°).

Characteristics Associated With Receiving Cataract Surgery in the US Medicare and Veterans Health Administration Populations.

Importance: Considerable variation exists with respect to the profiles of patients who receive cataract surgery in the United States.

Objective: To identify patient characteristics associated with receiving cataract surgery within the US Medicare and Veterans Health Administration (VHA) populations.

Design, Setting, And Participants: In this population-based retrospective cohort study of 3 073 465 patients, Medicare and VHA patients with a cataract diagnosis between January 1, 2002, and January 1, 2012, were identified from the 2002-2012 Medicare Part B files (5% sample) and the VHA National Patient Care Database.

Prevalence of primary open-angle glaucoma among patients with obstructive sleep apnea.

Objective: Our objective was to determine primary open-angle glaucoma (POAG) prevalence among obstructive sleep apnea (OSA) patients because the perioperative environment risks further damaging the optic nerve.

Study Design: We analyzed a "convenience sample" referred by Sleep Medicine for oral appliances because of continuous positive airway pressure intolerance. We determined the aggregate prevalence of the 3 POAG subtypes-"classic" open-angle glaucoma (COAG), normal-tension glaucoma (NTG), and open-angle glaucoma suspect (OAGS)-among the index population and compared it with that of same hospital's general population.

Comparison of Outcomes between Endoscopic and Transcleral Cyclophotocoagulation.

: Traditionally cyclophotocoagulation has been reserved as a treatment of last resort for eyes with advanced stage glaucoma, but increasingly it is offered to eyes with less severe disease. Endoscopic approaches in particular are utilized in increasing numbers of patients despite only a small number of publications on its results. : The purpose of this study was to compare the efficacy and safety of endoscopic and transcleral cyclophotocoagulation (ECP and TCP) procedures in eyes with refractory glaucomas.

Magnetic Resonance Imaging of Optic Nerve Traction During Adduction in Primary Open-Angle Glaucoma With Normal Intraocular Pressure.

Purpose: We used magnetic resonance imaging (MRI) to ascertain effects of optic nerve (ON) traction in adduction, a phenomenon proposed as neuropathic in primary open-angle glaucoma (POAG).

Methods: Seventeen patients with POAG and maximal IOP ≤ 20 mm Hg, and 31 controls underwent MRI in central gaze and 20° to 30° abduction and adduction. Optic nerve and sheath area centroids permitted computation of midorbital lengths versus minimum paths.

Facial Trauma: Delayed Development of a Subluxated Traumatic Cataract as Visualized on a Panoramic Image.

The immediate and long-term consequences of blunt orbital trauma leading to a subluxated lens and its subsequent calcification and opacification are reviewed. The accompanying panoramic image documents the process.

Trabeculectomy and Combined Phacoemulsification-Trabeculectomy: Outcomes and Risk Factors for Failure in Primary Angle Closure Glaucoma.

Purpose: To evaluate tonometric outcomes of patients with primary angle closure glaucoma (PACG) who have undergone trabeculectomy with mitomycin C (MMC) with and without concurrent phacoemulsification and to identify risk factors for postoperative failure.

Patients And Methods: Retrospective cohort study of 44 eyes of 33 phakic patients who underwent trabeculectomy with MMC with or without combined phacoemulsification for PACG. The primary endpoint was qualified tonometric success at 12 months according to predefined criteria.

Corneal Endothelium in Patients with Anterior Uveitis.

Purpose: To investigate a possible effect of intraocular inflammation on corneal endothelium by describing corneal endothelial cell density (ECD) and morphologic variables in eyes with anterior uveitis, and to investigate factors that may influence these findings.

Design: Cross-sectional, observational study. Observers were not masked.

Snapshot of Teleretinal Screening for Diabetic Retinopathy at the West Los Angeles Medical Center.

Introduction: The West Los Angeles Veterans Affairs Medical Center is a large urban facility with a robust teleretinal screening program in primary care clinic, established in 2006. The purpose of this article is to provide a snapshot of teleretinal screening at this site.

Methods: Diabetic patients from 2012 were analyzed with a prospective cohort study.

Meaningful correlation between asymptomatic retinal arteriole emboli and calcified carotid plaque found on panoramic dental imaging of males with diabetes.

Objective: There is ongoing controversy with regard to the stability of calcified carotid artery plaques (CCAPs) seen in the bifurcation area on panoramic images (PIs). Therefore, we sought to evaluate the possibility of these plaques shedding emboli by observing their relationship with ipsilateral retinal emboli.

Study Design: The study group included 50 neurologically and visually asymptomatic males with diabetes, with PIs that incidentally demonstrated CCAPs (CCAP+) and contemporaneous digital retinal images that had been obtained for evaluation of diabetic retinopathy.

Valved Glaucoma Drainage Devices in Pediatric Glaucoma: Retrospective Long-term Outcomes.

Importance: Relatively little data exist about the long-term outcomes of an initial glaucoma drainage device (GDD) and subsequent GDDs implanted in pediatric patients with glaucoma.

Objective: To determine the long-term outcomes of the first and second GDDs and risk factors in pediatric glaucoma.

Design, Setting, And Participants: Retrospective review of 119 eyes of 89 patients younger than 18 years with glaucoma who underwent valved GDD implantation from March 1999 to April 2012 at the Stein Eye Institute, University of California, Los Angeles.

Prospective Evaluation of Acupuncture as Treatment for Glaucoma.

Purpose: To evaluate acupuncture as treatment for glaucoma.

Design: Prospective double-masked randomized crossover study.

Methods: setting: Clinical practice.