A look back on what happened in optometry during the week ofMarch 27-March 31.
Catch up with what Optometry Times®' shared this week:
By Kensington Hatcher, OD, FAAO; Birva Shah, OD; Srinivas Kondapalli, MD
Age-related macular degeneration (AMD) is a multifactorial, progressive retinal disease and a leading cause of visual impairment. About 200 million people worldwide have AMD, and this number is expected to increase by nearly 50% over the next 20 years.1 It is critical that eye care providers accurately diagnose, educate, and monitor their AMD patients. Optical coherence tomography (OCT) is a useful tool to assess and track macular changes due to AMD, and OCT biomarkers can provide clues to help inform visual prognosis and progression risk.
OCT biomarkers are structural changes that can result from fluid (exudative AMD) or from alterations in the retinal layers (exudative or nonexudative AMD).2 Numerous biomarkers have been identified for advanced AMD. These biomarkers can aid in staging AMD, making treatment decisions, and assessing the likelihood of future progression.
By Lynda Charters
Investigators from Thailand, led by first author Phit Upaphong, MD, reported that moderate to severe Meibomian gland dysfunction (MGD) was treated successfully with a 3-week course of weekly oral azithromycin that was equivalent to a 6-week course of oral doxycycline.1
The 6-week treatment with doxycycline has frequently been associated with frequent gastrointestinal side effects that lead to decreased treatment compliance, which underscores the importance of the shorter treatment course.
The investigators conducted a double-masked, randomized clinical trial from September 2018 to May 2022. The study patients with moderate to severe MGD had been refractory to conservative management. The patients were randomized 1:1 to either oral azithromycin (1 gram once weekly for 3 weeks) or oral doxycycline (200 mg daily for 6 weeks), the authors recounted.
The main outcomeswere the total MGD score and Ocular Surface Disease Index (OSDI) score at the initial visit and 6 and 8 weeks and the adverse events at 6 and 8 weeks. The prespecified equivalence margins for the MGD score and OSDI score were set ±2 and ±9, respectively.
By Thomas A. Wong, OD, FNAP; Katheryn Cregan; Georgina Tsakrios, JD
Optic nerve head drusen (ONHD) are acellular hyaline deposits that aggregate within the prelaminar tissue of the optic nerve.1 Usually diagnosed early in life, ONHD are most likely to change in childhood but usually remain stable through adulthood.2 ONHD are estimated to occur in about 2.4% of patients.3
Many patients with ONHD are asymptomatic and their vision continues unaffected; however, ONHD can cause vision loss, nonarteritic anterior ischemic optic neuropathy (NAION), and peripapillary choroidal neovascular membranes. Although ONHD are usually an incidental finding during a routine exam, up to 10% of patients with them report transient visual obscurations.4 When located in more superficial layers of the optic nerve, drusen tend to take a pale color and can appear small as well as large and lobulated. When located deeper within the optic nerve, they can cause the optic nerve to take on a swollen or elevated appearance.1 Superficially located ONHD may be diagnosed with fundoscopy, but those more deeply located require additional testing to rule out other ocular pathology.
By David Hutton
A Texas ophthalmology provider group will pay nearly $3 million to resolve allegations that it offered and paid kickbacks to optometrists to induce patient referrals who were candidates for cataract surgery.
The U.S. District Court for the Eastern District of Texas then dismissed the civil action.
According to a news release from the United States Attorney’s Office, Eastern District of Texas, Arlington Ophthalmology Association, P.L.L.C. doing business as Kleiman Evangelista Eye Centers (K&E), with offices located in Arlington, Dallas, Plano, Southlake, Mount Pleasant, and Gun Barrel City, Texas, agreed to pay $2,902,505 to resolve False Claims Act allegations that it offered and paid kickbacks to optometrists to induce referrals of patients who were candidates for cataract surgery in violation of the False Claims Act and Anti-Kickback Statute.
By Maria Sampalis, OD; Kassi Jackson, Editor
In this week's podcast episode with Maria Sampalis, OD, shares how she got started with her practice's marketing.
By Lynda Charters
Israeli investigators reported that after the initial collagen crosslinking (CXL) for progressive keratoconus fails, the procedure can be repeated because it is safe and efficacious,1 according to lead author Ofri Vorobichik Berar, MD, and colleagues from the Department of Ophthalmology, Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Epithelial-off CXL can stabilize keratoconus, but the disease can continue to progress. Because the disease is vision-threatening, the investigators retrospectively reviewed the demographic, clinical, and surgical data from the cases of patients who required additional CXL.