Retinal vein thrombosis and risk of occult cancer:A nationwide cohort study

Abstract Background Retinal vein thrombosis has in case reports been reported a clinical sign of cancer, especially hematological cancer. However, it is unclear whether retinal vein thrombosis is a marker of underlying cancer, as is the case for deep venous thrombosis and pulmonary embolism. We investigated the risk of occult cancer in patients with retinal vein thrombosis. Methods A nationwide population‐based cohort study in Denmark on all patients diagnosed with a retinal vein thrombosis during 1994 and 2013. The main outcome measures were any cancer and site‐specific cancers <6 months, 6‐12 months, and 5 years following a retinal vein thrombosis diagnosis, as registered in the Danish Cancer Registry and the National Pathology Registry. We calculated the absolute cancer risk and computed standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) for cancer within <6 months, 6‐12 months, and 5 years following a retinal vein thrombosis diagnosis. Results Among 9589 patients with retinal vein thrombosis, we observed 1514 cancer cases. The risk of any cancer was 1.2% <6 months and 28.8% after 5 years. The <6 months SIR was 1.20 (95% CI 0.99‐1.44), 6‐12 months SIR was 1.15 (95% CI 0.94‐1.39), and the 5 years’ SIR was 1.08 (95% CI 1.03‐1.14). Stratification by age, gender, calendar year, and Charlson Comorbidity Index score did not change overall cancer risk estimates. Conclusion Retinal vein thrombosis was not an important clinical marker for occult cancer. An extensive diagnostic cancer workup does not appear warranted for retinal vein thrombosis patients

Clinical effectiveness of currently available low-vision devices in glaucoma patients with moderate-to-severe vision loss

Yogesh Patodia,1 Elizabeth Golesic,2 Alex Mao,2 Cindy ML Hutnik2 1Department of Medicine, Ross University, Iselin, NJ, USA; 2Department of Ophthalmology, University of Western Ontario, London, ON, Canada Purpose: The aim of this trial is to study the effectiveness of currently available low-vision devices in glaucoma patients with moderate-to-severe vision loss. Design: This is a randomized pilot clinical trial. Participants: Sixteen low-vision glaucoma patients participated in this study. Methods: Patients with a best-corrected visual acuity between 20/70 and 20/400 in the better eye and a diagnosis of stable primary or secondary open-angle glaucoma were randomized to a low-vision treatment group or a nonintervention control group. A telephone interview was conducted before and after the 4-week testing period to assess functional vision. Patients placed in the treatment group received a low-vision examination and used various currently available low-vision aids. Patients placed in the control group received a low-vision examination only. Changes in patients&rsquo; reading ability and overall visual ability were chosen as the primary outcomes. Other visual functioning domains (mobility, visual information processing and visual motor skills) were considered as secondary outcomes. Results: Ten patients in the treatment group showed a significant improvement in reading ability and overall visual ability compared to the control group. The difference in mean score for reading ability was 2.52 logits (2.02; P&lt;0.05) and overall visual ability was 0.78 logits (0.64; P&lt;0.05). However, no significant improvement was noted in the other visual functioning domains involving mobility and visual motor skills. Conclusion: Currently available low-vision devices primarily enhance central vision with limited benefits to functional activities relying on peripheral vision. Keywords: low vision, glaucoma, quality of life, activities of daily livin