Week in review: Subretinal drusenoid deposits and vascular disease, telehealth update, stress and the aging eye

A weekly roundup of ophthalmic news from around the web.

Check for subretinal drusenoid deposits today to prevent vascular disease tomorrow. This was the guidance from a cross-sectional cohort study conducted in 200 patients with AMD, 97 of whom had subretinal drusenoid deposits (SDDs). Forty-one percent of the patients with SDDs had high-risk vascular diseases (either myocardial or neurovascular in nature), compared with 7% of the patients with only drusen. The most commonly seen vascular diseases among the SDD group were stroke, univalve disease, and myocardial infarction. The authors recommend more retinal imaging and increased screenings for high-risk vascular diseases in patients with SDDs. BMJ Open Ophthalmology

Ophthalmic telehealth combined with asynchronous testing provides effective care. From January 2020 to July 2021, a period which mostly encompassed the first stages of the COVID-19 pandemic, the ophthalmology clinic at the University of California, San Francisco, implemented an asynchronous testing model to evaluate its utility for augmenting ophthalmology telehealth visits. Eighty-three percent of the asynchronous tests were for ocular hypertension or glaucoma. For 25% of the 126 telehealth encounters with asynchronous testing, data derived from the tests led to a change in clinical plan. Since at all points during the 18-month study period, the ophthalmology clinic had the fewest outpatient telehealth encounters per month among 11 specialty clinics there, the authors conclude that “this quality improvement study demonstrated the feasibility of enhancing ophthalmic telehealth with asynchronous testing, which was found to be effective for some subspecialty-level care,” adding that implementation of this approach into the community may help expand the reach of ophthalmic telehealth. JAMA Ophthalmology

Don’t stress yourself—it might make your eye age faster. A mouse-model study conducted at the University of California, Irvine (UCI), found that aging-related changes in the retina were sensitive to even mild elevations in IOP. Stress caused by repeated or long-lasting mild IOP elevation increased transcriptional responses and led to epigenetic and changes similar to those that occur during the natural aging process, including retinal ganglion cell death. Dorota Skowronska-Krawczyk, PhD, one of the authors of the published paper, commented on the study’s findings: “Our work emphasizes the importance of early diagnosis and prevention as well as age-specific management of age-related diseases, including glaucoma…This provides us with a window of opportunity for the prevention of vision loss, if and when the disease is recognized early.” University of California, Irvine; Aging Cell

How long is the preclinical detectable phase of open-angle glaucoma? About 10 years, say Swedish researchers. They collected data from a population-based screening of 33,000 people from 1992 to 1997 to determine eligibility for the Early Manifest Glaucoma Trial. Data from 1846 patients identified during the screening or at follow-up as having primary open-angle glaucoma or pseudoexfoliation glaucoma were included in this study. The mean length of the preclinical detectable phase (PCDP) for glaucoma was found to be between 10.1 and 10.7 years, based on both a prevalence/incidence model and a Markov chain Monte Carlo algorithm. Knowing even a general estimation of the PCDP can help clinicians to determine optimum glaucoma screening intervals. JAMA Ophthalmology