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    JAMA Ophthalmology

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    Amblyopia and Speech Perception

    January JAMA Ophthalmology

    Burgmeier et al. investigated the association of amblyopia with abnormal visual–auditory speech integration and found that children with a history of amblyopia do indeed have impaired speech perception.

    For this observational study, the researchers examined 33 children at least 3 years of age with no history of neurologic or hearing disorders. Mean follow-up was four years. Twenty-four children had a history of amblyopia in one eye, with a visual acuity of at least 20/20 in the nonamblyopic eye. Nine controls with a visual acuity of 20/20 in both eyes were also recruited. All participants were presented with a video demonstrating the McGurk effect. When an audio track playing the sound “pa” accompanies a simultaneous video track of a person articulating a “ka” sound, normal visual-auditory integration produces the perception of a fusion “ta” sound. Participants were asked to report which of the three sounds was perceived. The main outcome measure was the prevalence of the fusion “ta” sound.

    The McGurk effect was perceived by 11 of the 24 children with amblyopia (45.8 percent) and all nine controls. In addition, the effect was perceived by all children with amblyopia that was resolved by five years of age and by all children whose onset of amblyopia occurred at or after five years of age. Of the 16 children with amblyopia that was unresolved by five years of age, only three (18.8 percent) perceived the McGurk effect.

    Compounded Bevacizumab for Intravitreal Injection

    January JAMA Ophthalmology

    Bevacizumab acquired from compounding or repackaging pharmacies for intravitreal injection may cause infectious and noninfectious inflammation. In addition to safety issues, the drug itself may have variable efficacy associated with product aliquoting, handling, and distribution. In this study, Yannuzzi et al.investigated bevacizumab obtained from compounding pharmacies and found that despite variations in protein concentrations, these preparations were negative for microbial contaminants and endotoxin.

    This study included 21 compounded samples of bevacizumab prepared from 11 locations in the United States. Main outcome measures were microbial culture growth, endotoxin levels, and quantity and binding affinity of protein in each sample. No microbial contamination or endotoxin was detected in any of the samples. However, 17 (81 percent) had lower protein concentrations compared with bevacizumab acquired directly from Genentech. In three of the 10 compounding pharmacies where more than one sample was available, there were also substantial differences in the protein concentration between samples from the same pharmacy.

    The researchers noted that the clinical implications of this variability remain uncertain and should be the focus of future investigations.

    Injury Risk in Elderly Patients With Vision Disorders January

    JAMA Ophthalmology 

    In this retrospective study, Pineles et al. looked at the association between disorders of binocular vision and musculoskeletal injuries, fractures, and falls in the elderly. They found that people 65 years and older with strabismus, amblyopia, diplopia, and nystagmus are indeed at a higher risk of sustaining such an injury.

    The researchers analyzed a random sample of Medicare Part B fee-forservice claims for beneficiaries with binocular vision disorders who were 65 years or older with at least one year of Medicare Part B enrollment. The main outcome measure was the 10-year prevalence of musculoskeletal injury, fracture, or fall in individuals with and without a vision disorder. Analyses were adjusted for age, sex, race/ethnicity, region of residence, systemic and ocular comorbidities, and duration of follow-up.

    In total, 2,196,881 Medicare beneficiaries were identified. Of these, 99,525 (4.5 percent) had at least one reported disorder of binocular vision, including strabismus (2.3 percent), diplopia (2.2 percent), amblyopia (0.9 percent), and nystagmus (0.2 percent). During the study period, 1,272,948 patients (57.9 percent) had documented musculoskeletal injuries, fractures, or falls. The unadjusted odds ratio for the association between the disorders and any of the three injury types was 2.23; the adjusted odds ratio was 1.27.

    The researchers said the findings are a step toward developing strategies to prevent these injuries.

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    JAMA Ophthalmology summaries are based on authors’ abstracts as edited by senior editor(s).

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