Both high and low BP has been linked glaucoma. Low BP is particularly associated with glaucoma progression in normal-tension glaucoma (NTG) patients. Patients who have low nighttime BP readings are at highest risk of progression of their glaucoma. Internal medicine specialists and ophthalmologists should consider the relationship between BP and glaucoma when treating patients with concomitant disease. Too-low nighttime BP should be avoided. Ambulatory blood pressure monitoring is a useful tool to identify patients at greatest risk for progression.

Despite recognition that Acute Kidney Injury (AKI) leads to substantial increases in morbidity, mortality, and length of stay, accurate prognostication of these clinical events remains difficult. It remains unclear which approaches to variable selection and model building are most robust. We used data from a randomized trial of AKI alerting to develop time-updated prognostic models using stepwise regression compared to more advanced variable selection techniques. We randomly split data into training and validation cohorts. Outcomes of interest were death within 7 days, dialysis within 7 days, and length of stay. Data elements eligible for model-building included lab values, medications and dosages, procedures, and demographics. We assessed model discrimination using the area under the receiver operator characteristic curve and r-squared values. 2241 individuals were available for analysis. Both modeling techniques created viable models with very good discrimination ability, with AUCs exceeding 0.85 for dialysis and 0.8 for death prediction. Model performance was similar across model building strategies, though the strategy employing more advanced variable selection was more parsimonious. Very good to excellent prediction of outcome events is feasible in patients with AKI. More advanced techniques may lead to more parsimonious models, which may facilitate adoption in other settings.

How can we enrich the educational experience of medical students despite a steady decrease in ophthalmology content and exposure in the standard medical school curriculum? 1 We report a range of educational and scholarly opportunities offered by professional US ophthalmology organizations that may potentially be used to complement formal clinical teaching and maximize exposure to ophthalmology.Methods | Two investigators (A.Y. and X.Z.) independently reviewed the websites and bylaws of 17 major national ophthalmology organizations. Policies on membership, leadership (such as committee service and voting rights), annual meeting attendance, research and travel funding, annual membership fees, and early registration nonmember annual conference fees were recorded. Data were verified for accuracy through direct telephone and/or email correspondence with all organizations. The Yale Institutional Review Board determined this study to be exempt from review; therefore, no informed consent was obtained.Results | Of the 17 organizations, 4 (24%) offered membership to medical students, with 2 (50%) offering free memberships, and 9 (53%) offered memberships to residents, with 6 (67%) offering free memberships (Table ), all with restricted statuses distinct from regular or full membership. Overall, mean (SD) membership fees were $43

Nerve Infiltration Responds to Radiation and Blinatumomab A 52-year-old man with a history of Philadelphia chromosome negative B-cell acute lymphoblastic leukemia in remission presented with decreased vision in the right eye (OD) and headache. His visual acuity was count fingers OD and 20/20 left eye (OS). Fundoscopic examination revealed bilateral optic disc edema (Fig 1A and B). He was diagnosed with leukemic infiltration of the optic nerves. Treatment consisted of urgent radiotherapy and Blinatumomab, an anti-CD19 antibody that redirects T cells to enhance lysis of tumor cells. Six weeks after treatment, the visual acuity improved to 20/50 OD and remained 20/20 OS (Fig 1C and D).

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