Notes

Spatial Structure-Related Physical Points of interest Acknowledgement According to Lengthy Short-Term Recollection Protocol.
Generally, retinal gene therapy involves a subretinal or intravitreal injection of a viral vector, which infects target cells to deliver a therapeutic gene, or transgene. A gene augmentation strategy introduces a functioning copy of a gene to restore expression of a mutated gene, whereas a gene-editing strategy aims to directly edit and correct the mutation. Common delivery vectors include adeno-associated virus (AAV) and lentivirus.Voretigene neparvovec-rzyl (Luxturna) became the first FDA-approved direct gene therapy in December 2017, and the Australian TGA followed suit in August 2020. More are projected to follow, with clinical trials underway for many other IRDs.This review provides an overview of gene therapy for IRDs, including current progress and challenges. A companion article in this issue details target patient populations for IRD gene therapy, and how optometrists can assist in assessing individuals who may be eligible for current and future therapies.Clinical relevance Tear film assessment is essential in contact lens wearers and it can improve the success rates of the fitting.Background To compare the short-term effect of two contact lenses on pre-lens tear film stability and comfort dual-focus contact lens (MiSight) and a monofocal contact lens (Proclear 1-day).Methods This randomised, double-masked, crossover study was performed in twenty-eight healthy, myopic volunteers aged between 18 and 32 years (23.5 ± 4.1 years). Only one randomly chosen eye was assessed. Distance vision and refraction were evaluated at baseline. Each contact lens type (monofocal and dual-focus) was randomly fitted, always in both eyes. A visual analogue scale between 0 and 10 was used to assess general comfort, physical comfort, and visual comfort. Tear Film Surface Quality (TFSQ) index, TFSQ_area and auto Tear Break-Up Time were obtained using Medmont E-300 at baseline (naked eye condition) and 25 minutes after each contact lens insertion.Results Refractive sphere and cylinder d comfort during dual-focus contact lens wear.Clinical relevance The malignant potential of choroidal melanocytic tumours detected incidentally in the community is thought to be low, but this has not been assessed using a validated screening tool. An accurate characterisation of the malignant potential of these lesions has implications for resource allocation, service provision, education, and training.Background MOLES (Mushroom shape, Orange Pigment, Large size, Enlargement, and Subretinal fluid) categorises tumours as 'common naevus', 'low-risk naevus', 'high-risk naevus', and 'probable melanoma'. GW4064 The MOLES system recommends that patients with common naevi (score = 0) undergo review by a community optometrist every two years, ideally with sequential colour photography. For the remaining patients (score ≥ 1), specialist imaging and assessment are recommended, with referral triaged as non-urgent for patients with low-risk (score = 1) or high-risk naevi (score = 2) and urgent for patients with probable melanoma (score > 2).Methods Lesions flagged as choroidal melanocytic tumours on retinal photographs taken during the Australian National Eye Health Survey were retrospectively analysed by an ocular oncologist. Each lesion was assigned a MOLES score and categorised as common, low-risk, high-risk or probable melanoma.Results Seventy-seven choroidal naevi were identified. Seventy-five (97%) of the choroidal naevi were categorised as common naevi, with a MOLES score of 0. Two (3%) choroidal naevi had a score of 1 and diagnosed as low-risk naevi due to their size. No naevi had a score of 2 or more.Conclusion All choroidal naevi detected in this nationally representative population survey were innocuous. This suggests that the vast majority of choroidal melanocytic tumours that are incidentally detected in Australia can be managed in primary eye care settings without the need for specialist referral. MOLES provides a simple evidence-based method for choroidal naevi assessment in primary care.Clinical relevance Home-based videogame treatments are increasingly popular for amblyopia treatment. However, at-home treatments tend to be done in short sessions and with frequent disruptions, which may reduce the effectiveness of binocular visual stimulation. These treatment adherence patterns need to be accounted for when considering dose-response relationships and treatment effectiveness.Background Home-based videogame treatments are increasingly being used for various sensory conditions, including amblyopia ('lazy eye'), but treatment adherence continues to limit success. To examine detailed behavioural patterns associated with home-based videogame treatment, we analysed in detail the videogame adherence data from the Binocular tReatment of Amblyopia with VideOgames (BRAVO) clinical trial (ACTRN12613001004752).Methods Children (7-12 years), teenagers (13-17 years) and adults (≥ 18 years) with unilateral amblyopia were loaned iPod Touch devices with either an active treatment or placebo videogame and instt was characterised by short sessions interspersed with frequent pauses, suggesting regular disengagement. This complicates dose-response calculations and may interfere with the effectiveness of treatments like binocular treatments for amblyopia, which require sustained visual stimulation.Clinical relevance Understanding the quality of the commonly used clinical practice guidelines can help busy clinicians in selecting appropriate guidelines for evidence-based eye care for people with diabetes.Background The National Health and Medical Research Council's (NHMRC) clinical practice guideline on diabetic retinopathy management has been widely used locally and internationally for over 10 years. However, the quality of this guideline has never been formally assessed. This study aimed to systematically evaluate the quality of the NHMRC guideline and compare it against other international guidelines.Methods The 2008 NHMRC and another five established diabetic retinopathy management international guidelines (Scottish Intercollegiate Guidelines Network, 2017; American Academy of Ophthalmology, 2019; American Optometric Association, 2019; Royal College of Ophthalmologists, UK, 2013, and Canadian Ophthalmologic Society, 2012) were examined using the Appraisal of Guidelines, Research and Evaluation (AGREEto improve transparency in development and applicability in clinical practice.Clinical relevance In the last months, the whole world is dealing with an unprecedented public health crisis due to COVID-19 outbreak. Consequently, many governments have implemented lockdowns on a national level, affecting, among others, ophthalmic surgical practice in a globe scale.Background The aim of this study is to evaluate the impact of surgical theatre lockdown due to COVID-19 pandemic on the surgical performance of cataract surgeons.Methods Intraoperative complications and surgical time of the first 160 cataract surgeries performed by eight consultants (20 cases each) after a two-month lockdown were recorded and analysed in a cross-sectional study. The results were plotted against the last 30 cases of each surgeon before the implementation of the lockdown (240 cases). Cataract surgeons were asked to rate their subjective perspective and difficulties faced after re-opening through a questionnaire.Results The average duration of all surgeries after the lockdown was 19.1 ± 6.2 minutes showing a 14% incupon restart.Background This study investigates agreement in intraocular pressure measurements between three tonometers and Goldmann applanation tonometry (GAT); inter-optometrist agreement for each tonometer; intra-optometrist agreement for GAT; association between central corneal thickness (CCT) and IOP measurements with each tonometer.Methods IOP was measured using CT-1P Non-Contact Tonometer (NCT) (Topcon Corporation, Tokyo, Japan), Pulsair IntelliPuff (Keeler Ltd., Windsor, UK) and Icare rebound tonometer (Icare, Helsinki, Finland) by two optometrists in a random order. Two GAT readings were obtained by each optometrist in a randomised masked manner. Mean differences, and 95% limits of agreement (LoA) for each measurement were calculated. CCT was measured by CT-1P pachymeter.Results Forty-one participants' IOPs were measured. Mean differences (95% LoA) between NCT, Pulsair, Icare compared to GAT for one optometrist were 0.8 (-5.4 to 6.9) mmHg, -1.7 (-8.2 to 4.8) mmHg, -1.6 (-9.0 to 5.9) mmHg. Mean differences (95% LoA) in inter-optometrist agreement for GAT, NCT, Pulsair and Icare were 0.3 (-6.7 to 7.3) mmHg, 0.4 (-2.1 to 2.9) mmHg, -0.9 (-3.6 to 1.9) mmHg and -0.2 (-4.9 to 4.5) mmHg, respectively. Mean differences (95% LoA) for intra-optometrist agreement for GAT were 0.2 (4.3 to -4.7) mmHg and 0.1 (3.6 to -3.9) mmHg for each optometrist, respectively. There was a weak positive association between CCT and both GAT (r2 = 0.11) and NCT (r2 = 0.12).Conclusion Pulsair and Icare may measure IOP lower than GAT. Mean differences for inter-optometrist agreement for all tonometers were less then 1 mmHg; Pulsair showed a statistically significant difference. Intra-optometrist agreement for GAT was good. IOP measurements taken by two community optometrists are comparable using tonometers used in community practice.Clinical relevance Keratitis is common and studies of blindness throughout the world have found that corneal disease is the second most common cause of blindness.Background Microbial keratitis a bacterial, fungal, or protozoan disease of the cornea, characterised by a corneal infiltrate with an overlying epithelial defect and associated anterior chamber reaction.Methods Patients were identified through the hospital pathology database and a retrospective chart review of all patients with a positive corneal culture between 1999 and 2015 at Princess Alexandra Hospital was carried out.Results There were 895 records from 779 patients included and additional 107 records excluded. The average age of the included patients was 58.9 years (SD 21.0). Males made up 498 (55.6%) of the included patients. Contact lens microbial keratitis (CLMK) was the most common risk factor for MK and was significantly more common in younger patients. CLMK was significantly associated with cultures positive for Pseudomonas aeruginosa (p less then 0.001) while MK secondary to ocular surface disease and prior ocular surgery were more commonly associated with gram-positive organisms (p less then 0.001). Monotherapy with a fluoroquinolone was the most common treatment for patients with MK. Good outcomes were seen in 57% of patients.Conclusion In this patient group, contact lens wear was the most common risk factor for MK. Pseudomonas aeruginosa was the most common isolate.Clinical relevance The development of region-specific norms for the Developmental Test of Visual Perception, third edition (DTVP-3), from a group of children from South India will contribute to the assessment of visual-perceptual skills in children.Background Visual-perceptual skills are crucial for children to understand their environment, perform activities of daily living, and cope with their learning environment. These perceptual skills also influence children's behavioural characteristics. Well-constructed, norm-referenced standardised tools are vital for assessing visual-perceptual skills. Since ethnicity and cultural background may influence the performance of perceptual tasks, the proposed norms for any assessment tool need to be validated for specific populations. Hence, the current study aimed to develop norms in the Indian context for the Developmental Test of Visual Perception, third edition (DTVP-3), and compare the obtained norms with the norms established in the United States of America.Methods One hundred and thirty-seven healthy children (mean age 9.
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