To estimate the number of OCT scans necessary to detect moderate and rapid rates of retinal nerve fiber layer (RNFL) thickness worsening at different levels of accuracy using a large sample of glaucoma and glaucoma-suspect eyes.
Descriptive and simulation study.
Twelve thousand one hundred fifty eyes from 7392 adult patients with glaucoma or glaucoma-suspect status followed up at the Wilmer Eye Institute from 2013 through 2021. All eyes had at least 5 measurements of RNFL thickness on the Cirrus OCT (Carl Zeiss Meditec) with signal strength of 6 or more.
Rates of RNFL worsening for average RNFL thickness and for the 4 quadrants were measured using linear regression. Simulations were used to estimate the accuracy of detecting worsening-defined as the percentage of patients in whom the true rate of RNFL worsening was at or less than different criterion rates of worsening when the OCT-measured rate was also at or less than these criterion rates-for two different measurement strategies: evenly spaced (equal time intervals between measurements) and clustered (approximately half the measurements at each end point of the period).
The 75th percentile (moderate) and 90th percentile (rapid) rates of RNFL worsening for average RNFL thickness and the accuracy of diagnosing worsening at these moderate and rapid rates.
The 75th and 90th percentile rates of worsening for average RNFL thickness were -1.09 μm/year and -2.35 μm/year, respectively. Simulations showed that, for the average measurement frequency in our sample of approximately 3 OCT scans over a 2-year period, moderate and rapid RNFL worsening were diagnosed accurately only 47% and 40% of the time, respectively. Estimates for the number of OCT scans needed to achieve a range of accuracy levels are provided. For example, 60% accuracy requires 7 measurements to detect both moderate and rapid worsening within a 2-year period if the more efficient clustered measurement strategy is used.
To diagnose RNFL worsening more accurately, the number of OCT scans must be increased compared with current clinical practice. A clustered measurement strategy reduces the number of scans required compared with evenly spacing measurements.

Diabetic neuropathy is one of the common chronic complications of type 1 and 2 diabetes, involving the motor, sensory, and autonomic nerves of the central nervous system as well as the peripheral nervous system. When the optic nerve is involved, it is called diabetic optic neuropathy (DON). DON may or may not be associated with diabetic retinopathy. At present, ophthalmologists at home and abroad have insufficient understanding of DON, and early intervention will bring more benefits to the recovery of patients\' visual function. Therefore, the Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association has organized experts to put forward consensus opinions on the diagnosis and treatment of DON, which can help ophthalmologists to better understand and attach great importance to DON, and to do a good job in the screening and prevention of DON, so as to delay the occurrence and development of DON and protect the visual function of diabetes patients.
糖尿病神经病变是1型和2型糖尿病较为常见的慢性并发症之一，可累及中枢神经系统以及周围神经系统的运动、感觉和自主神经。视神经受累时称为糖尿病视神经病变（DON）。DON可合并或不合并糖尿病视网膜病变（DR）。目前国内外眼科医师对DON的认识尚存在不足，而早期干预会给患者视功能恢复带来更多益处。因此，中华医学会眼科学分会神经眼科学组组织专家针对DON的诊断和治疗提出共识性意见，旨在促进广大眼科医师认识并高度重视DON，做好DON的筛查和防治工作，以期延缓DON的发生和发展，努力保护糖尿病患者的视功能。.

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Intravitreal drug administration is a procedure that has become widespread in modern ophthalmology. However, there is no global consensus on certain aspects of this manipulation, and practitioners feel the need for guidelines. In the Russian Federation, until now, such a document was not available. The expert council on diseases of the retina and optic nerve of All-Russian public organization «Association of Ophthalmologists», with participation of invited specialists, has studied and analyzed the existing foreign guidelines for performing intravitreal injections, as well as the regulatory framework in Russia. As a result, this Protocol was developed and approved for use in the healthcare system of the Russian Federation. The document regulates the requirements for specialists and organizations, the conditions for performing the procedure and the necessary material resources and presents an algorithm for performing intravitreal drug administration, a patient examination check-list for various conditions of the procedure, as well as parameters for evaluating and monitoring the quality of the procedure.
Интравитреальное введение лекарственных препаратов — процедура, получившая широкое распространение в современной офтальмологии. Тем не менее, глобальный консенсус по отдельным аспектам выполнения этой манипуляции отсутствует, а практикующие врачи испытывают потребность в руководящих принципах. В Российской Федерации до настоящего времени такой документ отсутствовал. Экспертным советом по заболеваниям сетчатки и зрительного нерва Общероссийской общественной организации «Ассоциация врачей-офтальмологов» при участии группы привлеченных специалистов изучены и проанализированы имеющиеся зарубежные руководящие принципы по выполнению интравитреальных инъекций, а также действующая в России нормативно-правовая база. В результате был разработан и утвержден настоящий Протокол, предназначенный для применения в системе здравоохранения Российской Федерации. Документ регламентирует требования к специалистам и организациям, условия выполнения процедуры и необходимые материальные ресурсы. Представлены алгоритм выполнения интравитреального введения лекарственных препаратов, рекомендуемый перечень обследования пациентов при различных условиях выполнения процедуры, а также параметры оценки и контроля качества выполнения методики.

Glaucoma is a group of progressive optic neuropathies featuring retinal ganglion cell and axonal degeneration, which typically manifest as sunken atrophy of optic papilla and characteristic visual field defect. Genetic factors play an important role in the pathogenesis of glaucoma. This guideline mainly focuses on single gene mutation-related glaucoma by summarizing the pathogenic genes, disease diagnosis and clinical consultation of primary congenital glaucoma (PCG) and primary open-angle glaucoma (POAG), with an aim to regulate their molecular diagnosis, genetic counseling and treatment.

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The diagnosis of multiple sclerosis (MS) is dependent on the presence of clinical and paraclinical evidence demonstrating dissemination of central nervous system lesions in both space and time, as well as the exclusion of other disorders. Diagnostic criteria were originally promulgated in 1965 by the Schumacher committee and modified subsequently by the Poser committee to include paraclinical evidence. The most recent criteria are the 2010 modifications of the 2001 McDonald criteria, which are focused on making an earlier diagnosis of MS. This article provides guidelines, derived from clinical experience as well as evidence-based medicine, for the diagnosis and management of MS with special emphasis on practices in the Middle East.

BACKGROUND: To determine the anatomic and visual outcomes of patients with ophthalmic artery segment aneurysms treated at The Johns Hopkins Hospital using a consensus-based treatment algorithm.
METHODS: Retrospective record review of a prospectively accrued case series of 88 patients (101 aneurysms) treated between January 2004 and July 2009. Presenting symptoms and aneurysm parameters were recorded for all subjects. Treatment strategy for all patients was determined by consensus among neurosurgeons, neurointerventionalists, neurologists, and neuroophthalmologists meeting to review the clinical cases on a weekly basis. Final clinical outcomes (aneurysm control, functional status, and vision) were ascertained from in-house examinations, medical records, telephone interviews, or a combination of these methods. Risk factors for visual or other complications were evaluated.
RESULTS: An optic neuropathy was present in at least 30 (34%) of 88 patients after treatment. Presumed new visual loss occurred in 24 (27%) of these patients. The remaining 6 patients had preexisting optic neuropathy-related visual loss that worsened after treatment. No patient with a preexisting optic neuropathy improved following treatment.
CONCLUSIONS: Ophthalmic artery segment aneurysms present a treatment challenge because of their anatomic complexity and relationship to critical neural structures, particularly the visual sensory pathway. We have adopted a consensus-based treatment approach in an effort to optimize patient outcomes and aneurysm control. Although our approach resulted in durable treatment of the aneurysm, a sizable proportion of patients experienced new vision loss after treatment, and no patient with preexisting visual loss related to their aneurysm experienced visual improvement after treatment. We recommend that all patients with ophthalmic artery aneurysms receive careful and thorough preprocedural counseling to ensure they are aware of the risks and benefits of treatment regardless of the method used.