AAO Journal Archive
- Classification of Vitreous Seeds in Retinoblastoma
- Topical 5-Fluorouracil 1% as Primary Treatment for Ocular Surface Squamous Neoplasia
- Individualized Stabilization Criteria–Driven Ranibizumab versus Laser in Branch Retinal Vein Occlusion
- Correlation of Histologic Features with In Vivo Imaging of Reticular Pseudodrusen
- Pseudodrusen and Incidence of Late Age-Related Macular Degeneration in Fellow Eyes in the Comparison of Age-Related Macular Degeneration Treatments Trials
- Pharmacotherapies for Retinal Detachment
- Can Automated Imaging for Optic Disc and Retinal Nerve Fiber Layer Analysis Aid Glaucoma Detection?
- Suture Colonization Rate in Adjustable Strabismus Surgery
- Genetic and Dietary Factors Influencing the Progression of Nuclear Cataract
- Diagnostic Accuracy of Optical Coherence Tomography and Scanning Laser Tomography for Identifying Glaucoma in Myopic Eyes
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In our study,1 the original frequencies of epiretinal membranes reported were crude (33% in eyes with cataract surgery vs 19% in eyes without cataract surgery). When the frequencies of epiretinal membranes were adjusted for age, there was little change (33% vs 21%) and the age-adjusted P value remained at <0.001. Because these data are cross-sectional, we cannot infer the temporal relationship of the association from these data, that is, which is antecedent and which is consequent.
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The article by Jiang et al1 in the April 2015 issue of Ophthalmology is beautifully done. The authors are to be congratulated for commenting that the rim width “decreased” rather than the rim getting “thinner.” Thickness and width are not synonymous. The optic nerve head has both width and thickness, or narrowness and thinness. The “cup” of the optic nerve can become deeper (i.e., a change in thickness) or wider (i.e., a change in the lateral direction, not the anterior–posterior direction). The finding that width of the neural retinal rim becomes narrower in response to short-term elevations of intraocular pressure is a powerful commentary on the plasticity of the optic nerve head.
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We thank Professor Spaeth for his interest in our study and we fully agree with his comments on the plasticity of the optic nerve head as shown by the width of the neuroretinal rim of the optic nerve head getting narrower in response to a short-term increase in intraocular pressure.1,2 We also fully agree on the terminology he recommends, using the term narrowing for a decrease in the neuroretinal rim width in radial direction, and of using the term thinning for a decrease in the thickness of the rim as measured in sagittal direction.
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A 46-year-old woman presented with pain and an intraocular pressure of 63 mmHg in the left eye 2 years after plaque brachytherapy for uveal melanoma. Examination revealed pigmented material in the anterior chamber (Fig 1), a choroidal mass (Fig 2), and marked pigmentation in an open trabecular meshwork with gonioscopy. Histopathology of this blind, painful eye confirmed the diagnosis of spindle B type uveal melanoma (Fig 3), with foci of necrosis and pigment laden macrophages (melanophages). Melanophages (black arrow) were deposited on the ciliary body (CB), iris (I) and in the trabecular meshwork (white arrow, Fig 4; C indicates cornea).