Lehigh Valley Center For Sight

MAR 27, 2018 Glaucoma In this prospective observational trial, investigators explored whether corneal hysteresis (CH) could be used as a biomarker for identifying patients at risk for developing glaucoma. Study design The cohort comprised 199 glaucoma suspects (287 eyes) who were followed for an average of 3.9 years. All eyes had normal visual fields and CH measurements taken at baseline. Development of glaucoma was defined as 3 consecutive abnormal standard automated perimetry tests during follow-up. Outcomes Repeatable visual field (VF) defects developed in 54 eyes (19%) eyes during follow-up. All eyes in this group had significantly lower CH measurement at baseline compared with those who did not develop VF defects (9.5 mm Hg vs 10.2 mm Hg, P=0.012). A multivariate analysis revealed that each 1-mm Hg drop in baseline CH was associated with a 21% increased risk of developing glaucoma during follow-up. Limitations This study failed to identify IOP as a risk factor f

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To undergo Lasik correction, you need to make necessary preparations for the procedure. What you can expect before, during and after the surgery may depend to a large extent on your doctor. As part of your preparation for the Lasik correction , you need to make a firm decision if you will go through with the Lasik surgery. You need evaluation by your eye doctor to know if you are a good candidate for Lasik correction before you sign the waiver. Before you undergo Lasik correction you should stop wearing contact lenses. You should switch to wearing glasses full-time prior to lasik correction for at least 2 to 4 weeks. This is because the contact lens can change the shape of your cornea. Leaving your contact lenses out for several weeks will enable the cornea to assume its natural shape which is essential for the surgery. In Lasik correction procedure during surgery, you will be made to lie down on a reclining chair. A numbing eye drop will be placed in your eye. A ring will be plac

MAR 30, 2018 By Anni Griswold Comprehensive Ophthalmology, Pediatric Ophth/Strabismus, Retina/Vitreous A weekly roundup of ophthalmic news from around the web. The retina’s immune cell population can spring back after nearing extinction, according to a mouse study by scientists at the National Eye Institute. Therapies that harness this resilience could potentially curb inflammation and slow damage from retinitis pigmentosa or AMD, experts predict.  NEI A novel ocular insert could coax the cornea to absorb more antibiotics than ever before, say researchers at Valencia's CEU Cardenal Herrera University. The bioadhesive polymer fits under the eyelid and infuses the cornea with controlled doses of moxifloxacin. The insert outperformed eyedrops and creams in rabbits, but has yet to be tested in humans. Science Daily Firearms disproportionally injure the eyes of boys, teens and blacks, according to findings reported this week at the American Association for Ped

MAR 27, 2018 Glaucoma In this prospective observational trial, investigators explored whether corneal hysteresis (CH) could be used as a biomarker for identifying patients at risk for developing glaucoma. Study design The cohort comprised 199 glaucoma suspects (287 eyes) who were followed for an average of 3.9 years. All eyes had normal visual fields and CH measurements taken at baseline. Development of glaucoma was defined as 3 consecutive abnormal standard automated perimetry tests during follow-up. Outcomes Repeatable visual field (VF) defects developed in 54 eyes (19%) eyes during follow-up. All eyes in this group had significantly lower CH measurement at baseline compared with those who did not develop VF defects (9.5 mm Hg vs 10.2 mm Hg, P=0.012). A multivariate analysis revealed that each 1-mm Hg drop in baseline CH was associated with a 21% increased risk of developing glaucoma during follow-up. Limitations This study failed to identify IOP as a risk factor f

MAR 27, 2018 Glaucoma In this prospective observational trial, investigators explored whether corneal hysteresis (CH) could be used as a biomarker for identifying patients at risk for developing glaucoma. Study design The cohort comprised 199 glaucoma suspects (287 eyes) who were followed for an average of 3.9 years. All eyes had normal visual fields and CH measurements taken at baseline. Development of glaucoma was defined as 3 consecutive abnormal standard automated perimetry tests during follow-up. Outcomes Repeatable visual field (VF) defects developed in 54 eyes (19%) eyes during follow-up. All eyes in this group had significantly lower CH measurement at baseline compared with those who did not develop VF defects (9.5 mm Hg vs 10.2 mm Hg, P=0.012). A multivariate analysis revealed that each 1-mm Hg drop in baseline CH was associated with a 21% increased risk of developing glaucoma during follow-up. Limitations This study failed to identify IOP as a risk factor f

MAR 26, 2018 Cornea/External Disease, Refractive Mgmt/Intervention Investigators of this observational study examined topographical changes in patients with keratoconus while awaiting corneal crosslinking (CXL) treatment. Study design The prospective study included 104 patients diagnosed with keratoconus. Progression was defined as a change in the curvature within the cone area of at least 1 D on tangential map and a thinning of 20 μm at the thinnest point. Outcomes On average, patients waited for 84.8 days from the time of diagnosis to CXL treatment. During the waiting period, approximately one-quarter showed evidence of progression. Patients who progressed while waiting for treatment were younger than those who did not progress (22.2 vs. 25.4 years; P=0.02). Stratification by age groups showed a significant worsening of maximum keratometry in patients younger than 18 years compared with patients aged 18 to 26 years, or those older than 26 years (P=0.002 and 0.042,

MAR 20, 2018 By Keng Jin Lee Regeneron Pharmaceuticals, Inc. Retina/Vitreous Topline results from a phase 3 trial show that aflibercept effectively reversed nonproliferative diabetic retinopathy (NPDR) progression, according to an announcement by Regeneron Pharmaceuticals. The double-masked PANORAMA trial enrolled 402 patients who had moderately severe or severe NPDR without diabetic macular edema (DME). Patients were randomized to an observational sham injection group or 1 of 2 aflibercept treatment groups (i.e., 3 or 5 initial monthly doses, followed by an injection every 8 weeks). At the primary endpoint of 24 weeks, 58% of patients in the aflibercept arms experienced a 2-step or greater improvement from baseline on the Diabetic Retinopathy Severity Scale, compared with 6% in the sham arm. Patients received an average of 4.4 aflibercept injections during that period. There were no new safety signals in the trial. One case of mild intraocular inflammation

Two patients with advanced neovascular AMD have regained reading ability after receiving a specially engineered patch of retinal pigment epithelium (RPE) cells derived from stem cells. "We've restored vision where there was none,” lead investigator Lyndon da Cruz, MD, told the BBC .  Dr. da Cruz is a consultant retinal surgeon at Moorfields Eye Hospital in London and first author on the paper, which appeared in Nature Biotechnology on March 19, 2018 .   The team is the first to use a human embryonic stem cell (hESC)–derived RPE monolayer to treat AMD. In one previous stem cell study, Japanese scientists relied on induced pluripotent stem cells (iPSCs) , which minimize the risk of rejection but must be harvested from individual patients and grown for a lengthy period before they can be used. It’s exciting that the hESC-treated patients—a woman in her early 60s and a man in his 80s—did not require systemic immunosuppression, says Ajay Kuriyan, MD, a retina specialist and ass

MAR 23, 2018 By Anni Griswold Cataract/Anterior Segment, Comprehensive Ophthalmology, Cornea/External Disease, Retina/Vitreous A weekly roundup of ophthalmic news from around the web. “Reverse chocolate” is how researchers are describing an injectable liquid that warms into a drug-laden gel at body temperature. The biomedical startup AesculaTech says the gel has applications for pharmaceuticals, medical devices, cosmetics and textiles—but for now, they’ve set their sights on a once-a-year treatment for dry eye syndrome. Clinical trials are slated to start soon. TechCrunch “That’s $425,000 right there,” said Dr. Jack Comander. The surgeon from Mass. Eye and Ear made the remark when he placed syringes containing Luxturna—the gene therapy for inherited retinal dystrophy with a record sticker price —on the operating table. This week, the news site  STAT  published a feature on his patient: A 13-year-old named Jack Hogan  who is the first person in the United States

MAR 22, 2018 Genentech Retina/Vitreous Genentech announced the approval of a single-use syringe prefilled with 0.3 mg of ranibizumab for treating all forms of diabetic retinopathy (DR), with or without diabetic macular edema (DME). Made from borosilicate glass, the prefilled syringes are packaged in a sterile, sealed tray and allows physicians to eliminate several steps in preparing and administering ranibizumab. Physicians will not need to draw the medicine from a vial, disinfect the vial or attach a filter needle. Genentech expects the syringes to be available in the second quarter of 2018. The FDA previously approved a  single-use 0.5-mg ranibizumab prefilled syringe for treating wet AMD, myopic choroidal neovascularization and macular edema secondary to retinal vein occlusion “Diabetic retinopathy is a serious condition that affects millions of people in the U.S.,” said Sandra Horning, MD, chief medical officer and head of global product development. “Toda

Have you been wearing glasses all your life? Are you fed up of them and want to change how you look? Choose LASIK eye surgery and you can comfortably bid goodbye to your glasses and contact lenses forever. What is LASIK ? LASIK is an acronym for Laser Assisted in situ Keratomileusis. It is a refractive surgery procedure that is used to correct myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism in people who are over 18 years of age. It is a painless procedure and completed within minutes. First, your LASIK doctor performs an eye examination to evaluate the thickness of your cornea, pupil size and your overall health to find out if LASIK is right for you. Some people develop dry eyes after LASIK, so the possibility of that is also evaluated and your doctor will recommend a suitable LASIK treatment plan. However, be advised that LASIK is an elective procedure and you should check with your insurance company to find out if the costs will be covered. What is the p

MAR 20, 2018 Retina/Vitreous The authors investigated the effect of 2 tamponading agents on retinal thickness in eyes that underwent surgery for macula-on retinal detachment (RD). Study design The retrospective analysis included 33 eyes that received silicone oil tamponade and 31 eyes that received gas tamponade for the treatment of rhegmatogenous RD. The primary outcome measure was the change in thickness of each retinal layer in the central 1 mm zone, as determined by spectral domain OCT. Outcomes At 6 months postop, eyes in the silicone oil group had a statistically significant decrease in total retinal thickness. All retinal layers, with the exception of the photoreceptor layer, were significantly thinner (P<0.001). In contrast, eyes in the gas group did not experience any significant changes in total retinal thickness or in the measurements of any individual retinal layer. Postoperative BCVA in the silicone oil group was significantly worse than the gas grou

MAR 20, 2018 Cataract/Anterior Segment, Cornea/External Disease This retrospective analysis examined risk factors for early graft detachment in Descemet membrane endothelial keratoplasty (DMEK). Study design The authors examined 173 eyes that underwent DMEK at a single institution. They identified 59 eyes with any level of graft detachment, and examined the demographic, co-morbidity, donor, and surgical parameters of these eyes. Outcomes The authors identified 2 key findings. First, eyes undergoing triple procedures (cataract extraction, intraocular lens implant and DMEK) had a higher risk of detachment than eyes undergoing DMEK alone (OR 5.31; P<0.002). Second, eyes with less than 75% of residual air bubble at 2-3 hours postoperatively were more likely to experience graft detachment (OR 2.66; P=0.27). Limitations Aside from its retrospective nature, this study only examines the rate of detachment. While it may be considered a strength, it is also limiting in th

MAR 06, 2018 Retina/Vitreous Patients who undergo uncomplicated vitreoretinal surgery can safely be examined on the second postoperative day without negative effects, according to this small study. Study design This was a single-surgeon retrospective review of 134 patients who underwent vitreoretinal surgery. Each was seen on the second, but not the first day, after surgery. All patients received a phone call from a technician on the first day after surgery to assess for pain and vision issues. Outcomes Six patients had IOP greater than 30 mm Hg on the second postoperative day; all were managed medically. Only 1 patient was seen on the first postoperative day due to pain and elevated pressure. There were no cases of endophthalmitis. Limitations The very rare but potential complication of endophthalmitis can be missed if a patient is not seen on postoperative day 1. The effect of elevated IOP—even for 1 day—in a patient with ischemic retina could lead to some loss of

MAR 08, 2018 U.S. Food and Drug Administration Comprehensive Ophthalmology, Uveitis Sagent Pharmaceuticals announced a voluntary nationwide recall of 10 lots of methylprednisolone sodium succinate (40mg, 125mg and 1g) due to high impurity levels detected during routine quality testing. The products were manufactured by Gland Pharma Ltd. Methylprednisolone sodium succinate is an anti-inflammatory glucocorticoid indicated for a number of conditions, including various ophthalmic diseases. The product is supplied in 5 ml, 10 ml, and 30 ml glass tubular vials. The lot numbers being recalled were distributed to hospitals, wholesalers and distributors nationwide from April 2017 through February 2018. A detailed list of products and lots is provided in the table below. Product Lot Numbers Expiration Date NDC Number Distribution Dates Methylprednisolone Sodium Succinate for Injection, USP, 40mg AJM601 AJM701 AJM702

MAR 16, 2018 By Anni Griswold A weekly roundup of ophthalmic news from around the web. Keratoconus crept up on Ravens defensive tackle Brandon Williams with little warning, “like I got sand in my eye almost,” he recalls.  After waiting more than 2 years for the FDA to approve Avedro’s corneal crosslinking system , the athlete recently underwent the procedure and has recovered vision in both eyes. The Baltimore Sun Avedro’s newest crosslinking system may eliminate the epithelium-stripping step. The FDA has greenlighted a phase 3 efficacy trial of an epi-on corneal collagen crosslinking protocol for progressive keratoconus. If all goes to plan, the year-long multicenter, randomized study will enroll 275 patients and conclude in mid-2020. Avedro Donated skin samples from a family in New York may help scientists find a breakthrough treatment for cone-rod dystrophy. The family carries a mutated ATF6 gene, which meddles with blood vessel development in utero and hinders

MAR 16, 2018 Retina/Vitreous This retrospective, multicenter case series examined the long-term visual outcomes of 27-gauge pars plana vitrectomy in patients with posterior segment disease. Study design The authors examined postoperative visual acuity and complications in 390 eyes that underwent vitrectomy with 27-gauge instrumentation. Cases involving multiple-gauge instrumentation or concurrent glaucoma or corneal surgery were excluded. Patients who underwent concurrent phacoemulsification were included in the study. Outcomes Overall logMAR visual acuity improved from 0.72 to 0.40 over an average follow-up period of 715 days (minimum follow-up of 365 days). Statistically significant visual improvements were noted in patients with epiretinal membrane, macular hole, vitreous hemorrhage, diabetic tractional detachment, retained lens material and endophthalmitis. Transient postoperative hypotony occurred in 5.6% of eyes and was statistically associated with angled scl

MAR 14, 2018 Ocular Pathology/Oncology This retrospective case series examined outcomes of patients undergoing iodine-125 plaque brachytherapy for juxtapapillary choroidal melanoma. Study design The analysis included 47 patients with juxtapapillary choroidal melanoma treated with iodine-125 notched brachytherapy at a single center. The cohort was divided into apex low-dose (≤84.35 Gy) and high-dose (>85.35 Gy) groups. Main outcome measures were time to distant failure, local failure, death, enucleation, radiation retinopathy, optic neuropathy and best corrected visual acuity. Outcomes Low-dose iodine-125 plaque brachytherapy (67.5–81 Gy at tumor apex) provided distant failure, local failure, death and enucleation rates comparable with those observed in the high-dose group. The authors demonstrated that there are potentially superior outcomes in terms of reduced radiation retinopathy and optic neuropathy for lower dose brachytherapy. Limitations Patients in this

This study examines the clinical course of atypical pituitary adenoma with orbital invasion, a rare and aggressive condition that is often refractory to treatment. Study design The authors present a single case of pituitary adenoma invasion into the orbit, and review the disease course and treatment of this case combined with the 22 other cases reported to date. Outcomes Researchers describe the clinical features of a 31-year-old man who presented with biopsy-proven atypical pituitary adenoma invading the right orbit after a prior resection. The patient was treated with radiation, somatuline depot and temozolomide, but continued to experience recurrent tumor growth in the orbital cavity. Immunohistochemical staining of a biopsy specimen revealed high immunoreactivity. The patient experienced further vision loss, proptosis, ophthalmoplegia and cranial nerve palsies, consistent with an aggressive, refractory intracranial neoplasm. Among the 22 additional cases of pituitary adenomas w

MAR 12, 2018 By Keng Jin Lee Regeneron Pharmaceuticals, Inc. Retina/Vitreous A recent spike in cases of intraocular inflammation among patients receiving aflibercept (Eylea) appear linked with specific batches of syringes, according to Regeneron Pharmaceuticals. The increase in safety reports related to intraocular inflammation was first noted by the American Society of Retina Specialists (ASRS) in October 2017, and first reported by Bloomberg  last month. In a letter to healthcare providers dated February 28, Regeneron said they conducted an extensive review of manufacturing and distribution processes. The review did not find any association with the anti-VEGF drug itself, but an association was seen with certain batches of the syringe that were included in the following lots of final packaged EYLEA kits: While it’s not issuing a formal recall, Regeneron has ceased distributing the affected kits out of an abundance of caution and recommends that practitio

Chinese researchers have unveiled a new class of retinal prosthesis that relies on nanotechnology to restore the light response. Unlike other subretinal prostheses, the new device—an array of gold-flecked nanowires—replaces damaged photoreceptors and interfaces directly with neurons, averting the need for additional electronic hardware. If the findings hold up in humans, the device could potentially aid people with degenerative eye conditions such as retinitis pigmentosa or macular degeneration. The approach might also prove useful for reversing vision loss from nondegenerative conditions, such as trauma or retinal detachment. “The authors have taken a novel approach to fixing a problem that affects the vision of tens of millions of people worldwide,” says Sunir Garg, MD, co-director of the retina research unit at Wills Eye Hospital and Editor-in-Chief of Retina Times . One existing retinal prosthesis, the Argus II (Second Sight), relies on glasses with a built-in video camera to tr

This multicenter retrospective study explored clinical features that distinguish ocular sarcoidosis from other forms of uveitis. The authors also estimated the sensitivity and specificity of the International Workshop on Ocular Sarcoidosis (IWOS) guidelines for characterizing uveitis patients suspected of having sarcoidosis. Study design Medical records from 884 uveitis patients from 19 centers in 12 countries were included in the final analysis. Of these, 167 had sarcoidosis that was confirmed from a positive biopsy or from evidence of bilateral hilar lymphadenopathy (BHL) on chest radiograph or CT scan. Outcomes Among sarcoidosis cases, the most common clinical findings were bilateral disease (86%), snowballs or string of pearls (50%), mutton-fat keratic precipitates, iris nodules or both (46%) and chorioretinal peripheral lesions (37%). As expected, chest x-ray, angiotensin converting enzyme (ACE) levels and lysozyme levels were neither sensitive nor specific. The authors compa

MAR 09, 2018 By Keng Jin Lee SightLife Surgical Cataract/Anterior Segment, Refractive Mgmt/Intervention AcuFocus will sell the Kamra technology to Seattle-based SightLife Surgical , according to a press release on the company’s website. Approved by the FDA in April 2015 , the Kamra inlay is the first device for surgical correction of presbyopia. The ultra-thin, opaque, donut-shaped implant creates a small-aperture effect that provides an extended depth of focus in presbyopic patients who have not had cataract surgery Dr. Minoru Tomita, who has performed more than 6,000 Kamra procedures in Japan, discusses the advantages of the inlay in this interview from AAO 2016 . “The Kamra inlay is a minimally invasive solution for a greatly underserved and growing segment of the population,” said Richard L. Lindstrom, MD, a surgeon at Minnesota Eye Consultants and board member for both AcuFocus and SightLife Surgical. “I’m excited about the progress achieved today and t

Blepharitis has long been the neglected stepchild of eye pathologies, never receiving the attention bestowed upon cataracts, glaucoma and retinal disease. Another poorly understood syndrome, dry eye disease, is seemingly all the rage now with articles, new treatment modalities and specialty treatment centers. It is possible that these 2 elusive diseases are not only closely related, but one and the same in terms of etiology, pathology and progression? New approach to dry eye Standard dogma dictates that dry eye disease is quite complicated, with an overlapping disease presentation that stems from multiple etiologies. Based on this understanding, it would be heresy to suggest that dry eye is anywhere close to a simple process. A new theory of dry eye has recently emerged, however, and is gaining traction among eye practitioners as well as opinion leaders in eye disease. In a 2016 paper in Clinical Ophthalmology , we proposed that blepharitis and dry eye are actually one simple condit

MAR 09, 2018 By Anni Griswold and Keng Jin Lee Cataract/Anterior Segment, Comprehensive Ophthalmology, Retina/Vitreous A weekly roundup of ophthalmic news from around the web. A 22-year old woman’s mysterious visual and auditory symptoms led ophthalmologists on a trail of discovery in an “Images in Medicine” feature published last week . After ruling out syphilis, herpes and tuberculosis, clinicians settled on a rare diagnosis: Cogan’s syndrome. Systemic glucocorticoids quickly curbed the inflammatory condition, restoring the woman’s sight and hearing within 1 month of initiating treatment. New England Journal of Medicine The eyes use a special trick to memorize details of visual scenes , researchers report. An eyetracking study revealed that adults move their eyes in a distinct pattern as they memorize objects on a screen, then repeat that pattern when they stare at a blank screen and recall the objects. "The same way a person repeats the digits of a phon

MAR 07, 2018 By Keng Jin Lee Clearside Biomedical Uveitis Clearside Biomedical announced that their proprietary formulation of triamcinolone acetonide (CLS-TA) improved vision in patients with macular edema noninfectious uveitis. Injecting triamcinolone into the suprachoroidal space with a single-use microinjector enabled efficient delivery to the posterior segment, while limiting exposure to the anterior segment. The phase 3 PEACHTREE trial included 160 patients. Ninety-six were randomized to the treatment arm and received two 4.0 mg doses of suprachoroidal CLS-TA 12 weeks apart. The remaining 64 patients underwent sham procedures at the same 12-week interval.  At the 24-week follow-up, 47% of CLS-TA patients gained at least 15 ETDRS letters, compared with 16% of controls (P<0.001). The study arm also showed significantly better mean improvements in BCVA (13.7 vs. 2.9 letters) and central subfield thickness (-157 vs. -19 microns) relative to controls. T

MAR 05, 2018 Ocular Pathology/Oncology Investigators of this prospective study compared the efficacy of Müller muscle-conjunctival resection (MMCR) to external levator advancement (ELR) for aponeurotic blepharoptosis repair. Study design Patients with mild to moderate ptosis with good levator function and a positive phenylephrine test were randomized to MMCR (38 eyes) or ELR (39 eyes). The primary outcome was margin reflex distance 1 (MRD1) at 1 month after surgery. Secondary outcomes were cosmetic outcomes, complications and operating time. Outcomes Both groups showed significant and comparable improvements in MRD1 at 1-month postop. Cosmetic outcomes were significantly better in the MMCR group than the ELR group (3.07 vs. 2.69, respectively; P=0.020), whereas average operating room time was similar between the 2 procedures (71 vs. 75 minutes, respectively; P=0.439). One eye in the MMCR group and 3 eyes in the ELR group underwent reoperation. Limitations The mai

MAR 06, 2018 Retina/Vitreous Patients who undergo uncomplicated vitreoretinal surgery can safely be examined on the second postoperative day without negative effects, according to this small study. Study design This was a single-surgeon retrospective review of 134 patients who underwent vitreoretinal surgery. Each was seen on the second, but not the first day, after surgery. All patients received a phone call from a technician on the first day after surgery to assess for pain and vision issues. Outcomes Six patients had IOP greater than 30 mm Hg on the second postoperative day; all were managed medically. Only 1 patient was seen on the first postoperative day due to pain and elevated pressure. There were no cases of endophthalmitis. Limitations The very rare but potential complication of endophthalmitis can be missed if a patient is not seen on postoperative day 1. The effect of elevated IOP—even for 1 day—in a patient with ischemic retina could lead to some loss of

FEB 27, 2018 By Anni Griswold Iridex Cataract/Anterior Segment, Comprehensive Ophthalmology, Retina/Vitreous Iridex has voluntarily recalled its TruFocus LIO Premiere laser accessory following 3 reports of permanent vision loss from focal cataracts and retinal burns during laser treatments with the device, according to an announcement on the company’s website . The LIO is a headmounted indirect ophthalmoscope that connects to an IRIDEX laser console. The company is urging clinicians to stop using TruFocus LIO Premiere ophthalmoscopes with part numbers 87300, 87301, 87302, 87303 and 87304. Recalled products were distributed from June 5, 2017 to January 29, 2018. Iridex has notified the Food and Drug Administration of the recall, and has asked distributers and customers to return the 104 TruFocus LIO Premiere units currently in circulation worldwide. Questions can be directed to the company’s technical support team at +1-844-357-9485 (United States), +1-650-962

Comprehensive Ophthalmology, Neuro-Ophthalmology/Orbit, Ocular Pathology/Oncology Spaceflight-associated neuro-ocular syndrome is a newly described condition characterized by hyperopic shift, disc edema, globe flattening, choroidal folds and cotton wool spots following space travel and prolonged exposure to microgravity. Using OCT, the authors describe changes in the optic nerve head and surrounding tissue in astronauts after a 6-month mission. Study design The authors monitored 15 astronauts who underwent OCT imaging before and after a 6-month long mission to the International Space Station. They quantified morphological changes in various ocular structures, and compared findings from the astronauts and 43 healthy controls. Outcomes After returning from their mission, investigators noted increases in total retinal thickness and retinal nerve fiber layer thickness, which were most pronounced in the region closest to the optic nerve head rim margin. There were no changes in chor

MAR 02, 2018 By Keng Jin Lee and Anni Griswold Comprehensive Ophthalmology, Cornea/External Disease, Neuro-Ophthalmology/Orbit A weekly roundup of ophthalmic news from around the web. Allergan's deal with a Native American tribe to shelter Restasis’ patents has hit a roadblock . In September, Allergan sold the patents for its top-selling dry eye drug (cyclosporine ophthalmic emulsion 0.5%) to the Saint Regis Mohawk tribe to block generic competition. The tribe motioned to dismiss other companies’ patent challenges on the basis of sovereign immunity. But the U.S. Patent Trial and Appeal Board ruled that tribal immunity doesn't apply to inter partes reviews—so the charges will stand. STAT News Indiana could become the second state after Oklahoma to ban scleral tattoos, a dangerous practice that could lead to permanent vision loss and even enucleation . A committee on Monday unanimously backed the proposal , which some called "the grossest bill of the