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Optometry and Vision Science 2019 Year-end Review

Twa, Michael D.

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doi: 10.1097/OPX.0000000000001460
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This year in science has provided some major advances and some enduring challenges. On the global stage, China continues to grow as a formidable force in research and discovery as it has for the last several decades. The total number of citable documents published worldwide in 2018 (the most recent full year) has grown to 3.5 million from 3.4 million in 2017. During this same period, the U.S. National Science Foundation reported that China had, for the first time, overtaken the United States in total scientific publications. Reports from SCImago show nearly equivalent numbers of publications for the two countries (United States: 570,104; China: 569,227). However, the citations to those publications remain higher in the United States (528,000; ranked first) compared to China (399,000; ranked second). Another way to compare the impact of scientific output is to look at the h-index, which combines the number of publications and the number of citations to those publications. The United States has a 2018 h-index of 2222 (2222 articles cited 2222 or more times), followed by the United Kingdom (1373), Germany (1203), Canada (1102), and France (1094). China ranks 13th in h-index (794). For those who enjoy publication metric trivia, San Marino was the country with the highest rank for citations per article (15.3) and a total of 38 publications, which emphasizes the potential folly associated with metric abuse. The 2019 investments in research and development by the United States are estimated at $581 billion (and growing slowly), with China at $519 billion and climbing steadily and rapidly ($400 billion in 2018). China's investments in research funding will likely eclipse gross research and discovery spending in the United States within the next 5 years (Fig. 1). The United States remains the world's top destination for students seeking advanced research training (PhD and postdoctoral students). In summary, the research landscape continues to expand with growing influence from China and other eastern countries who have made significant investments in research infrastructure over the past several decades.

Estimated global research expenditures are shown by country for 2019. Expenditures in the United States were $581 billion and China was $519 billion.

Federal research funding continues to be a source of lively debate in the United States and despite presidential promises to severely curtail research funding and radically change the structure of the National Institutes of Health, Congress has effectively united to defend health research funding. With strong support from Congress, the National Institutes of Health and the National Eye Institute have received modest increases in funding for the last 2 years. However, the National Eye Institute remains one of the smallest branches of the National Institutes of Health, which is literally eight times smaller than the largest National Institutes of Health branch, the National Cancer Institute (Fig. 2).

U.S. congressional funding over time. Total NIH funding across all institutes is shown in blue and funding to the National Eye Institute is shown in green.

In vision research, dry eye research continues to gain momentum, and we should expect to see additional developments targeting novel supplements, pharmaceuticals, and biologicals over the coming years. Myopia control is continuing to flourish as a clinical practice strategy and as an area of ongoing research innovation. Contact lens designs for myopia are an area of active development with the first FDA clearance for a myopia control lens approved in November of this year. Pharmacologic compounds and innovative spectacle lens designs are also likely to undergo review by the U.S. FDA in the near future. Clinical interventions are becoming more widely practiced, and there is an ongoing need for additional research to understand the underlying mechanisms as well as clinical evidence to support the most effective practices. The routine use of scleral contact lenses is continuing to grow, and common uses include keratoconus, postsurgical applications, and anterior segment rehabilitation. Innovations in lens materials and designs continue to improve patient comfort and experience. These lenses may also be a viable platform to deliver wavefront-optimized visual corrections for patients.

In 2019, scientific advances in biomedicine continued to be dominated by discoveries in cell biology and genetics. In an animal study, vision researchers gave ocular injections of nanoparticles and produced mice that were able to see infrared light as well as visible light. A single injection had minimal side effects and bestowed infrared vision for up to 10 weeks, allowing them to see infrared light even during the day. These findings have intriguing implications for human infrared vision. Stem cell transplant therapies for retinal degenerations and other neurological diseases including spinal cord injuries and multiple sclerosis continue to be explored and show promise. Gene editing techniques are rapidly becoming an important strategy in biomedical research to modify genetic material as a way to repair or silence mutations. A group in China has reportedly edited genes in human embryos in 2015, and this continues to raise important ethical concerns and debates about appropriate uses.

Some interesting advances were seen in quantum computing in 2019 as researchers led by Google's AI Quantum team demonstrated the power of quantum computing. The team created a chip that greatly outperformed a classical computer. Their reported achievement in computing speed completed a massive computing task in 3 minutes—something that reportedly would have taken the world's fastest supercomputer 10,000 years. IBM also launched a commercial quantum computing initiative to provide research and business access to quantum computing capabilities. In another computing-related development, synthetic DNA strands were used to store massive amounts of data. DNA in the human body contains massive amounts of stored information, and researchers have now shown that a few grams of DNA can safely store an exabyte of data (one quintillion bytes) and keep it intact for thousands of years. The process of converting 0 s and 1 s into the DNA molecules adenine, thymine, cytosine, and guanine is not yet ready for commercial implementation, but scientists are making meaningful progress. Harvard Life Lab's Catalog is scheduled to launch a prototype machine next year that is said to be capable of encoding a terabit of data per day. Perhaps this will be the future archival format for scholarly publications!

As always, we will continue to bring you advances in these and many more areas over the coming year. We are looking forward to two feature issues this year: one on the uses of imaging in glaucoma management and one on advances in the use of scleral lenses. We will also have some new introductions to make as new Editorial Board members join the team in January. To each of you who serves the journal as a reviewer and takes the time to carefully and thoughtfully consider the work of your peers, to those who make it a priority to participate in the peer-review process despite all other responsibilities that you may have, to those of you who serve your patients, the profession, the American Academy of Optometry, and the larger community of scientists and clinicians, thank you for your service. 2019 Has been a great year, and we are looking forward to 2020.

© 2019 American Academy of Optometry