Demographic Trends at the American Academy of Ophthalmology Annual Cornea Subspecialty Day.

PURPOSE: The purpose of this study was to identify trends in female representation and years since training completion among speakers and moderators at the American Academy of Ophthalmology (AAO) Annual Cornea Subspecialty Day between 2007 and 2022. METHODS: Speakers and moderators at each AAO Cornea Subspecialty Day from 2007 to 2022 were sorted by sex and year of training completion. Sex and time from training completion were identified based on the individual's institutional profile or publicly available databases. RESULTS: Five hundred eighty-three speakers and 48 moderators were identified from the AAO Cornea Subspecialty Day meeting archives over 15 years. Overall, women represented 199 (34.1%) speakers and 19 (39.6%) moderators. The proportion of female speakers increased from 10.0% in 2007 to 54.8% in 2022 (P < 0.001). The ratio of female moderators increased from 4 of 21 (19.0%) in 2007 to 2014 to 15 of 27 (55.6%) in 2015 to 2022 (P = 0.017). In years where there were less than 50% female moderators, women represented 26.3% of speakers versus 44.4% of speakers in years with greater than 50% female moderators (P = 0.014). Female speakers were overall earlier in practice than male speakers, with fewer average years since training completion (16.4 ± 1.8 vs. 22.3 ± 2.1 years; P < 0.001). CONCLUSIONS: Female representation among speakers and moderators at AAO's Cornea Subspecialty Day increased between 2007 and 2022. Sessions with a majority of female moderators were associated with a higher number of female speakers. Female speakers were generally earlier in their career than male speakers. These trends highlight the overall increases in female representation in academic ophthalmology.

Impact of iris color on uveal melanoma-related outcomes in 7245 patients at a single ocular oncology center.

PURPOSE: To determine the relationship between iris color and uveal melanoma (UM)-related metastasis and death in a large cohort of patients from a single ocular oncology center. DESIGN: Retrospective case series. SUBJECTS: Patients diagnosed with UM between February 1971 and August 2007. METHODS: Patient information was obtained from chart documentation. MAIN OUTCOME MEASURES: UM-related metastasis and death. RESULTS: Out of 7245 patients, iris color was blue in 3702 (51%), green in 1458 (20%), and brown in 2085 (29%). Mean age was 58 ± 15 years and mean tumor thickness was 5.5 ± 3.3 millimeters. Some clinical features differed between iris color groups, with the blue irides group having a larger proportion of post-equatorial tumors with significantly closer proximity to the foveola and optic disc compared to the brown irides group. At a mean follow-up of 75 months, there was no statistically significant difference in metastasis between the various iris color groups. On univariate analysis, those with blue irides showed a higher incidence of UM-related death compared to the green and brown irides groups (8.3%, 5.9% and 7.5% respectively, p value = 0.02). Kaplan-Meier event free survival from UM-related death significantly differed only between the blue and green irides groups (p value = 0.007) with the green irides group showing the highest survival. However, on multivariate analysis, iris color was not predictive of UM-related death. CONCLUSION: Iris color was not predictive of UM-related metastasis or death. However, Kaplan-Meier survival at 20 years was poorest for blue irides group compared to green.

Ocular Tumor in a Woman With Breast and Kidney Carcinomas.

A 54-year-old woman with a history of lobular breast carcinoma in situ as well as chromophobe kidney cell carcinoma was referred for evaluation of an asymptomatic, amelanotic choroidal mass in her left eye. Examination revealed a hyperautofluorescent amelanotic lesion primarily in the sclera that pushed and thinned the overlying choroid. What would you do next?

Cephalopod retinal development shows vertebrate-like mechanisms of neurogenesis.

Coleoid cephalopods, including squid, cuttlefish, and octopus, have large and complex nervous systems and high-acuity, camera-type eyes. These traits are comparable only to features that are independently evolved in the vertebrate lineage. The size of animal nervous systems and the diversity of their constituent cell types is a result of the tight regulation of cellular proliferation and differentiation in development. Changes in the process of development during evolution that result in a diversity of neural cell types and variable nervous system size are not well understood. Here, we have pioneered live-imaging techniques and performed functional interrogation to show that the squid Doryteuthis pealeii utilizes mechanisms during retinal neurogenesis that are hallmarks of vertebrate processes. We find that retinal progenitor cells in the squid undergo nuclear migration until they exit the cell cycle. We identify retinal organization corresponding to progenitor, post-mitotic, and differentiated cells. Finally, we find that Notch signaling may regulate both retinal cell cycle and cell fate. Given the convergent evolution of elaborate visual systems in cephalopods and vertebrates, these results reveal common mechanisms that underlie the growth of highly proliferative neurogenic primordia. This work highlights mechanisms that may alter ontogenetic allometry and contribute to the evolution of complexity and growth in animal nervous systems.

Relationship between Fitzpatrick Skin Type and The Cancer Genome Atlas Classification with Melanoma-Related Metastasis and Death in 854 Patients at a Single Ocular Oncology Center.

BACKGROUND: The Fitzpatrick Skin Type (FST) is an objective method of classifying patients based on skin color and sunburn sensitivity. The Cancer Genome Atlas (TCGA) is a method of determining the prognosis of patients with uveal melanoma based on genetic composition of the tumor. There is no literature studying the relationship of FST and TCGA groups. MATERIALS AND METHODS: Retrospective cohort study on 854 patients with uveal melanoma treated at a single tertiary ocular oncology center between April 2006 and June 2020, classified based on FST on a scale of I-VI and based on genetic analysis with TCGA classification on a scale of A, B, C, and D. Outcome measures included uveal melanoma-related metastasis and death per FST and TCGA group. RESULTS: Patients classified as FST I (compared to FST II and III-V) had higher odds of being TCGA group D (OR 2.34, p = 0.002). Patients classified as FST III-V (compared to FST I and II) had higher odds of being TCGA group B (OR 2.26, p = 0.002). Kaplan-Meier survival analysis showed no difference in melanoma-related metastasis or death comparing FST I vs. II vs. III-V within each TCGA group at 5, 10, and 15 years. CONCLUSIONS: Patients classified as FST I are more likely to have a higher grade melanoma on genetic testing whereas those classified as FST III-V show lower grade melanoma. Despite differences in tumor features and genetic profile with various FST, survival analysis at 5, 10, and 15 years revealed no difference in melanoma-related metastasis or death within each TCGA group per skin tone.