Resistance to immune checkpoint therapies by tumour-induced T-cell desertification and exclusion: key mechanisms, prognostication and new therapeutic opportunities.

Immune checkpoint therapies (ICT) can reinvigorate the effector functions of anti-tumour T cells, improving cancer patient outcomes. Anti-tumour T cells are initially formed during their first contact (priming) with tumour antigens by antigen-presenting cells (APCs). Unfortunately, many patients are refractory to ICT because their tumours are considered to be 'cold' tumours-i.

Epigenetic control of expression as a mechanism of resistance to immune checkpoint therapy in poorly immunogenic melanomas.

Immune Checkpoint Therapies (ICT) have revolutionized the treatment of metastatic melanoma. However, only a subset of patients reaches complete responses. Deficient β2-microglobulin (β2M) expression impacts antigen presentation to T cells, leading to ICT resistance.

Obstructive sleep apnoea and glaucoma: a systematic review and meta-analysis.

Introduction: Obstructive sleep apnoea (OSA) has been thought to be associated with glaucoma, however there are many conflicting studies on this topic. With many new studies having been published since the previous meta-analysis, we believe it is important to clarify this association. Hence, in this study we meta-analyse the recent literature regarding the association between OSA and glaucoma.

Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration.

Neovascular age-related macular degeneration (nAMD) is a major cause of visual impairment and blindness. Anti-vascular endothelial growth factor (VEGF) agents, such as ranibizumab, bevacizumab, aflibercept, brolucizumab and faricimab have revolutionized the clinical management of nAMD. However, there remains an unmet clinical need for new and improved therapies for nAMD, since many patients do not respond optimally, may lose response over time or exhibit sub-optimal durability, impacting on real world effectiveness.

Evolving treatment paradigms for PCV.

Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular AMD (nAMD) that accounts for a significant proportion of nAMD cases worldwide, and particularly in Asia. Contemporary PCV treatment strategies have closely followed those used in typical nAMD, though there are significant gaps in knowledge on PCV management and it remains unclear if these strategies are appropriate. Current clinical trial data suggest intravitreal anti-vascular endothelial growth factor (VEGF) therapy alone or in combination with photodynamic therapy is effective in managing haemorrhage and exudation in PCV, although the optimal treatment interval, including as-needed and treat-and-extend approaches, is unclear.

Applying Single-Cell Technology in Uveal Melanomas: Current Trends and Perspectives for Improving Uveal Melanoma Metastasis Surveillance and Tumor Profiling.

Uveal melanoma (UM) is the most common primary adult intraocular malignancy. This rare but devastating cancer causes vision loss and confers a poor survival rate due to distant metastases. Identifying clinical and molecular features that portend a metastatic risk is an important part of UM workup and prognostication.

Efficacy and safety of intravitreal aflibercept for polypoidal choroidal vasculopathy: 96-week outcomes in the Japanese subgroup of the PLANET study.

Purpose: To evaluate the efficacy and safety of intravitreal aflibercept (IVT-AFL) versus IVT-AFL plus rescue photodynamic therapy (IVT-AFL + rPDT) in the subgroup of Japanese patients with polypoidal choroidal vasculopathy (PCV) enrolled in the PLANET study.

Study Design: A 96-week, double-masked, sham-controlled phase-3b/4 randomized clinical trial conducted at multiple centers from May 2014 to August 2016.

Patients And Methods: Patients with PCV (BCVA 73-24 ETDRS letters [20/40-20/320 Snellen]) received 3 initial monthly doses of IVT-AFL 2 mg.

Mucous Membrane Pemphigoid with Ocular Involvement: The Clinical Phenotype and Its Relationship to Direct Immunofluorescence Findings.

Purpose: This study explored the validity of the First International Consensus on Mucous Membrane Pemphigoid (MMP) guidance, which recommends that clinically indistinguishable patients, who have direct immunofluorescence (DIF)-negative biopsies, be excluded from a diagnosis of MMP. Misdiagnosis, or delayed diagnosis, of MMP with ocular involvement leads to the inappropriate use of topical therapy, the standard of care for causes of cicatrising conjunctivitis other than MMP, rather than systemic immunomodulatory therapy, resulting in irreversible clinical deterioration in patients with MMP.

Design: Prospective, cross-sectional study.

Hypotrichosis and juvenile macular dystrophy caused by CDH3 mutation: A candidate disease for retinal gene therapy.

Hypotrichosis with juvenile macular dystrophy (HJMD) is an autosomal recessive disorder that causes childhood visual impairment. HJMD is caused by mutations in CDH3 which encodes cadherin-3, a protein expressed in retinal pigment epithelium (RPE) cells that may have a key role in intercellular adhesion. We present a case of HJMD and analyse its phenotypic and molecular characteristics to assess the potential for retinal gene therapy as a means of preventing severe visual loss in this condition.

Myopia in asian subjects with primary angle closure: implications for glaucoma trends in East Asia.

Purpose: To evaluate the occurrence of myopia in Asian subjects with angle closure and to assess the ocular biometric parameters in these subjects.

Design: Cross-sectional study.

Participants: We prospectively recruited 427 angle-closure subjects (143 primary angle-closure suspects, 75 patients with primary angle closure, 165 patients with primary angle-closure glaucoma, and 44 patients with acute primary angle closure) from a Singapore hospital.

Intraocular pressure spikes after a sequential laser peripheral iridotomy for angle closure.

Objective: To determine the incidence of intraocular pressure (IOP) spikes within the first 30 minutes after sequential argon-Nd:YAG laser peripheral iridotomy (LPI) in patients with angle closure and to explore risk factors for their occurrence.

Methods: A total of 428 consecutive eyes of 298 patients who had undergone LPI at the Singapore National Eye Centre between June 2011 and August 2011 were reviewed retrospectively. There were 238 primary angle closure suspect eyes, 85 primary angle closure eyes, 92 primary angle closure glaucoma eyes, and 13 acute primary angle closure (APAC) eyes.

Effect of prophylactic laser iridotomy on corneal endothelial cell density over 3 years in primary angle closure suspects.

Objective: To assess the effect of prophylactic laser peripheral iridotomy (LPI) on corneal endothelial cell density (ECD) and morphology in primary angle closure suspects (PACS) over 3 years.

Methods: In this prospective cohort study, subjects underwent LPI in one eye, while the fellow eye was untreated. Specular microscopy was performed at baseline and after 1 and 3 years.

Comparison of two spectral domain optical coherence tomography devices for angle-closure assessment.

Purpose: To compare two spectral domain optical coherence tomography (SD-OCT) devices for the identification of angle structures and the presence of angle closure.

Methods: This was a prospective comparative study. Consecutive patients underwent gonioscopy and anterior segment imaging using two SD-OCT devices (iVue and Cirrus).

Pseudophakic rhegmatogenous retinal detachment in a large Asian tertiary eye centre: a cohort study.

Background: To determine the incidence and identify risk factors for the development of rhegmatogenous retinal detachment in patients who had cataract surgery at the Singapore National Eye Centre between 2001 and 2003.

Design: Retrospective case-control study.

Participants: All patients who had cataract surgery between 2001 and 2003 and subsequently retinal detachment surgery in the same eye, between 2001 and June 2008, at Singapore National Eye Centre.

An unusual causative agent for an orbital abscess: Granulicatella Adiacens.

We present a patient who developed an orbital abscess secondary to a retained organic (wooden) foreign body after a fall. Clinically, he had a right sub brow fistula exuding purulent discharge, four millimetres of proptosis, limitation of ocular motility in all directions of gaze, but no signs of optic neuropathy. Preoperative computed tomography and magnetic resonance imaging of the orbits was performed to localise the abscess and to facilitate surgical planning.

Efficacy of medical therapy in the initial management of acute primary angle closure in Asians.

Purpose: Recent studies have advocated the use of laser iridoplasty or paracentesis in the initial management of patients with acute primary angle closure (APAC). The aim of this study was to ascertain the effectiveness of medical treatment consisting of topical and systemic intraocular pressure (IOP)-lowering agents in the initial management of APAC.

Methods: This was an observational case series of consecutive patients presenting with APAC at a Singapore hospital over 2 years.

Nasolabial fold angle measurement using anterior segment optical coherence tomography in normal subjects.

Purpose: The human nasolabial fold angle (NFA) has been measured using MRI and photogrammetry and has been shown to decrease with age. The authors aimed to evaluate a novel method using optical coherence tomography to measure the NFA.

Methods: In this cross-sectional observational series, the authors used anterior segment optical coherence tomography (ASOCT) to image the NFA of both cheeks of 126 subjects aged 21 to 79 years.

Development of thyroid-related orbitopathy following cataract surgery.

Aim: To report a case series of patients who had manifestation or aggravation of thyroid related orbitopathy (TRO) following cataract surgery in an Asian eye centre.

Methods: A systematic review of clinical records of patients with manifestation or aggravation of TRO was conducted. Inclusion criteria were manifestation or aggravation of TRO within 6 months of cataract surgery.

Diabetes, metabolic abnormalities, and glaucoma.

Objective: To examine the relationship of diabetes mellitus and metabolic abnormalities with intraocular pressure and glaucoma.

Methods: A population-based study was conducted in 3280 (78.7% response) Malay adults aged 40 to 80 years.

Plateau iris in Asian subjects with primary angle closure glaucoma.

Objective: To determine the prevalence of plateau iris in Asian eyes with primary angle closure glaucoma (PACG) using ultrasound biomicroscopy (UBM).

Methods: In this cross-sectional observational study, subjects older than 40 years with PACG who had a patent laser peripheral iridotomy underwent UBM in 1 eye. Ultrasound biomicroscopy images were qualitatively analyzed using standardized criteria.

Population prevalence of tilted and torted optic discs among an adult Chinese population in Singapore: the Tanjong Pagar Study.

Objective: To determine the prevalence of tilted and torted optic discs and associated risk factors among Chinese adults in Singapore.

Methods: As part of a population-based survey, optic disc stereophotographs of both eyes were obtained, and left eyes were analyzed using imaging software. A tilted optic disc was defined as an index of tilt (ratio of minimum to maximum optic disc diameter) less than 0.

Screening for narrow angles in the singapore population: evaluation of new noncontact screening methods.

Purpose: To assess the screening effectiveness of 3 new noncontact devices, the scanning peripheral anterior chamber depth analyzer (SPAC) (Takagi, Nagano, Japan), which measures peripheral anterior chamber depth (ACD); IOLMaster (Carl Zeiss Meditec, Jena, Germany), which measures central ACD; and Visante anterior segment optical coherence tomography (AS-OCT) (Visante, Carl Zeiss Meditec, Dublin, CA), which images the angles, and to compare these instruments with gonioscopy in identifying people with narrow angles (NAs).

Design: Cross-sectional, observational, community-based study.

Participants: Phakic subjects aged >or=50 years without ophthalmic symptoms who were recruited from a community polyclinic in Singapore.

Use of optical coherence tomography to assess variations in macular retinal thickness in myopia.

Purpose: To investigate the variation in macular retinal thickness in otherwise normal young Asian myopic subjects by using optical coherence tomography (OCT).

Methods: One hundred thirty ophthalmically normal men 19 to 24 years of age with myopia (spherical equivalent, -0.25 to -14.

A review of trabeculectomy in East Asian people--the influence of race.

Glaucoma is the leading cause of irreversible blindness worldwide. East Asians account for approximately half of all glaucoma sufferers. It is likely that trabeculectomy will be needed for many of these people as the intraocular pressure is to be maintained at a satisfactorily low level.

Defining "occludable" angles in population surveys: drainage angle width, peripheral anterior synechiae, and glaucomatous optic neuropathy in east Asian people.

Background: /aim: A current consensus in epidemiological studies of primary angle closure (PAC) is to diagnose the condition only if the posterior (usually pigmented) trabecular meshwork is seen for less than 90 degrees of the angle circumference, termed an "occludable angle." The authors sought to assess the validity of this epidemiological classification by exploring the relation between drainage angle width, peripheral anterior synechiae (PAS) and glaucomatous optic neuropathy (GON).

Methods: 918 Mongolians and 995 Chinese Singaporeans, both groups aged 40 years and older were examined in two population based surveys.