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Introduction:Many diabetics do not have regular eye examinations, although it is known that early diagnosis and treatment of sight-threatening retinopathy reduces the risk of blindness. The barriers that prevent diabetics from attending eye clinics are poorly understood. Purpose:To determine what factors may influence diabetic patients' attendance at eye clinics. Methods: A qualitative survey of both patients and eye care providers was undertaken in a rural district general hospital and in an urban tertiary teaching hospital. Methods employed included semi-structured interviews, focus groups and non-participatory observations. All interviews and discussions were recorded and transcribed. The transcripts were then analyzed to detect emerging themes. Data collection continued until no new themes emerged. Results: Lack of awareness was seen as the greatest barrier by both patients and providers. Patients were aware that diabetes could affect the eye, but not that it could lead to blindness, nor that severe retinopathy could be asymptomatic. Patients reported that fundus images used for screening were a valuable educational resource. Fear, particularly of laser treatment, and guilt, about poor control causing retinopathy, deterred patients from attending. Both patients and providers recognized that regular attendance was inconvenient; however, providers underestimated the difficulties patients faced in obtaining time off work to attend clinics. Conclusion: Providing more complete information about diabetic retinopathy, and making eye clinic attendance more convenient for patients, may increase the number of diabetics who have regular eye examinations. [ABSTRACT FROM AUTHOR]

Retinal detachment (RD) is a serious and common condition, but genetic studies to date have been hampered by the small size of the assembled cohorts. In the UK Biobank data set, where RD was ascertained by self-report or hospital records, genetic correlations between RD and high myopia or cataract operation were, respectively, 0.46 (SE = 0.08) and 0.44 (SE = 0.07). These correlations are consistent with known epidemiological associations. Through meta-analysis of genome-wide association studies using UK Biobank RD cases (N = 3 977) and two cohorts, each comprising ~1 000 clinically ascertained rhegmatogenous RD patients, we uncovered 11 genome-wide significant association signals. These are near or within ZC3H11B, BMP3, COL22A1, DLG5, PLCE1, EFEMP2, TYR, FAT3, TRIM29, COL2A1 and LOXL1. Replication in the 23andMe data set, where RD is self-reported by participants, firmly establishes six RD risk loci: FAT3, COL22A1, TYR, BMP3, ZC3H11B and PLCE1. Based on the genetic associations with eye traits described to date, the first two specifically impact risk of a RD, whereas the last four point to shared aetiologies with macular condition, myopia and glaucoma. Fine-mapping prioritized the lead common missense variant (TYR S192Y) as causal variant at the TYR locus and a small set of credible causal variants at the FAT3 locus. The larger study size presented here, enabled by resources linked to health records or self-report, provides novel insights into RD aetiology and underlying pathological pathways., (© The Author(s) 2019. Published by Oxford University Press.)

Purpose: To study UK practice patterns for the management of retinal detachment secondary to macular hole (MHRD) and macular retinoschisis (MRS) in pathological myopia (PM). To review the anatomical and visual outcomes of the surgically managed cases., Methods: A prospective observational case series for the management of MHRD was undertaken in association with the British Ophthalmological Surveillance Unit (BOSU). The results were combined with retrospective data, collected by the COllaboration of British RetinAl Surgeons (COBRA), on the management of both MHRD and MRS in PM in the UK. A total of 20 cases of MHRD and 53 cases of MRS (27 surgical cases and 26 cases managed conservatively) are reported in this combined study., Results: MHRD: Mean baseline best corrected visual acuity (BCVA) was 1.60 logMAR. All cases underwent pars plana vitrectomy (PPV). Mean post-operative BCVA was 1.49 logMAR (p = 0.674). The macular hole was closed in 5/20 (25%) cases, open/flat in 10/20 (50%) cases and open/elevated in 4/20 cases (20%). MRS: Mean baseline BCVA was 0.87 logMAR in the surgical group and 0.45 logMAR in the conservatively managed group (p = 0.002). All eyes that had surgical intervention underwent PPV. Mean post-operative BCVA was 0.68 logMAR (p = 0.183). Anatomical outcomes demonstrated a persistent MRS in 2/27 (7.4%) cases, partial resolution in 7/27 (25.9%) cases and complete resolution in 16/27 (59.2%) cases., Conclusions: PPV is the only surgical procedure performed for the management of MHRD and MRS amongst the study participants. Success rates and visual outcomes are limited for MHRD and consistent with the current literature for MRS.