Ophthalmology
Pathophysiology of diabetic macular oedema: why combination therapy may be better
The prevalence of diabetes has continued to increase over the years. It is currently estimated that there are 382 million with diabetes worldwide in 2013, and that this figure is expected to rise to 592 million by 2035 [1]. In...
Strategies for managing neovascular AMD and DMO in routine clinical care
Treatment practice in the management of neovascular age-related macular degeneration (AMD) and diabetic macular oedema (DMO) illustrate increasing adoption of patient-tailored treatment approaches based on initial diagnosis and regular monitoring of imaging and visual outcomes in routine clinical care. The...
Genetic profiling for personalised healthcare solutions in AMD – an update
Age-related macular degeneration (AMD) is a multifactorial condition influenced by genetics and lifestyle factors (Table 1). This article outlines several recent advances in AMD genetics, as well as evolving therapeutic concepts and established practical measures for the treatment and /...
Intravitreal injections delivered by ophthalmic clinical nurse specialists
Intravitreal injections of the anti-vascular endothelial growth factor (anti-VEGF) agent ranibizumab, for the treatment of wet age-related macular degeneration (AMD) was approved by National Institute for Health & Care Excellence (NICE) in 2008 [1]. The Manchester Royal Eye Hospital (MREH),...
Anterior segment imaging: a photographer’s view
My name is Rosalyn Painter and I work within the vision science and ophthalmic imaging team at Bristol Eye Hospital, where we cover all aspects of imaging within the hospital, including fluorescein angiograms, fundus photography, optical coherence tomography (OCT), slit-lamp...
What’s next in retinal imaging? Faster, deeper and full-on
Fast-evolving technological leaps are opening the way toward clinically useful ocular coherence angiography, generating 3-dimensional microvasculature maps without intravenous dye injection, as well as whole-eye imaging, handheld patient-operated optical coherence tomography (OCT) devices and, for challenging vitreoretinal procedures, integrated intraoperative...
Myasthenia gravis presenting with isolated ptosis: a poorly studied subgroup
Investigation into the cause of one isolated symptom or sign can be challenging if that particular sign may be caused by a variety of pathological processes, affecting different tissues, and presenting to different specialties. Unilateral ptosis is a case in...
Shifting the paradigm of managing patients in medical retina: how real-world data can help us to improve clinical practice
The ophthalmic subspecialty of ‘medical retina’ has undergone dramatic changes in recent years. With the introduction of ranibizumab (Lucentis, Novartis), a specialty formerly dominated by laser-based therapies has been transformed to become, in large part, pharmacotherapy-based. To date, these pharmacotherapies...
Retinopathy of prematurity treatment in the South West of England: long-term outcomes 1997-2008
Retinopathy of prematurity (ROP) is a condition that affects the developing retinal vascular system of pre-term babies. If left untreated, ROP can lead to severe visual impairment. The severe visual impairment caused by untreated ROP can be prevented by screening...
Management of proliferative diabetic retinopathy
Diabetic retinopathy is a major cause of blindness in the working-age population. Due to the worsening global epidemic of diabetes, the incidence of morbidity caused by the disease is set to increase [1]. The prevalence of diabetes in the UK...
How to examine the visual system Part 2: Accommodation, pupils, fundoscopy and additional tests
Examining the visual system can be a tricky skill for medical students to master, yet it is a task that is frequently tested in examinations. This is the second of a two-part series of articles, which together aim to improve...
NICE drugs: an update on what’s good to go
Treatment options recommended by the National Institute for Health and Care Excellence (NICE) must be readily available for use in the NHS of England and Wales. This article provides an overview of recent guidance from NICE and summary advice issued...
