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Current Opinion in Ophthalmology

Wen Fan Hu, Sherleen H Chen
PURPOSE OF REVIEW: Continuous curvilinear manual capsulorhexis is currently the standard of cataract surgery. In the past several years, new technologies have been developed to improve the consistency and safety of capsulorhexis creation. This article reviews the most recent technologies in capsulotomy formation and their advantages and disadvantages. RECENT FINDINGS: Guidance devices, femtosecond laser capsulotomy and precision pulse capsulotomy improve the centration, circularity and precision of anterior capsulorhexis and capsulotomy...
November 1, 2018: Current Opinion in Ophthalmology
Majid Moshirfar, Benjamin Buckner, Yasmyne C Ronquillo, Daniel Hofstedt
PURPOSE OF REVIEW: To review the literature in 2017 and 2018 pertaining to biometry for cataract surgery and report pertinent findings. RECENT FINDINGS: New devices using swept-source ocular coherence tomography can measure axial length in dense cataracts more frequently than common biometers. Computer-assisted registration may be superior to intraoperative aberrometry for toric intraocular lens (IOL) placement. Soft contact lenses may not require removal as long before biometry as previously thought...
November 1, 2018: Current Opinion in Ophthalmology
Ari Brandsdorfer, Sejal H Patel, Roy S Chuck
PURPOSE OF REVIEW: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used and studied by cataract surgeons for varied benefits in the perioperative period, but optimal medication formulae and dosing have yet to be established. In this article, we perform a literature review of articles published between 1 January 2016 and 30 June 2018 concerning perioperative NSAID use for patients undergoing cataract surgery. RECENT FINDINGS: Literature review revealed five areas of recent study including preoperative NSAID use for iatrogenic inflammation, intraoperative NSAID use for pupillary mydriasis, postoperative NSAID use for prevention of cystoid macular edema (CME), for prevention of pain/inflammation, and for improvement in patient quality of life...
October 30, 2018: Current Opinion in Ophthalmology
Siyuan Li, Ying Jie
PURPOSE OF REVIEW: This review aims to introduce recent updates in cataract surgery and lens implantation. RECENT FINDINGS: Compared to phacoemulsification, femtosecond laser-assisted cataract surgery (FLACS) may offer benefit for cataract patients with other complicated ocular diseases, such as corneal disease and vitreous abnormalities. Meanwhile, several types of novel intraocular lenses (IOLs) have been introduced to the market, and each of them has particular features in improving patients' visual acuity...
October 17, 2018: Current Opinion in Ophthalmology
Soosan Jacob
PURPOSE OF REVIEW: To review the different methods of chopping in cataract surgery. RECENT FINDINGS: Chop techniques are of advantage in reducing the amount of phaco energy, endothelial damage as well as zonular stress to the eye. Various methods have been described including the classical horizontal and vertical chops as well as newer chop techniques for all grades of cataract. Femtochop using the femtosecond laser as well as the use of a microinterventional snare are more recent advances...
October 16, 2018: Current Opinion in Ophthalmology
Ruti Sella, Natalie A Afshari
PURPOSE OF REVIEW: To provide a comprehensive summary of the latest evidence-based data on nutrients linked to the pathogenesis of cataract formation and progression. RECENT FINDINGS: This summary of peer-reviewed publications emphasizes the ongoing effort to modulate the cataractogenous process through nutrition, and points at an only weak evidence for the contribution of a specific nutrient to this process. Although observational studies successfully demonstrated a positive correlation between specific nutrients intake and age-related cataract, such evidence was usually lacking in following interventional studies...
October 12, 2018: Current Opinion in Ophthalmology
Khoi Tran, Kaivon Pakzad-Vaezi
PURPOSE OF REVIEW: Diabetic retinopathy is the most common microvascular complication of diabetes mellitus and a leading cause of blindness throughout the world. Ocular imaging continues to play a vital role in the diagnosis, management and monitoring of diabetic retinopathy. Major technological advancements in imaging over the past decade have improved our understanding and knowledge of diabetic retinopathy and therefore a multimodal approach to imaging has become the standard of care...
November 2018: Current Opinion in Ophthalmology
Ashlin Joye, John A Gonzales
PURPOSE OF REVIEW: This review highlights recent studies that have increasingly implicated cytomegalovirus (CMV) as a significant cause of keratouveitis and retinitis in immunocompetent hosts. RECENT FINDINGS: Molecular testing has identified that CMV infection is frequently present in cases of Posner-Schlossman and Fuchs, keratouveitis syndromes previously presumed to be idiopathic conditions. Ocular hypertension and endothelial cell loss are important complications of CMV keratouveitis and are likely mediated by viral invasion of the trabecular meshwork and corneal endothelium...
November 2018: Current Opinion in Ophthalmology
Bo Young Chun, Dean M Cestari
PURPOSE OF REVIEW: Myelin oligodendrocyte glycoprotein (MOG)-IgG-associated optic neuritis has been established as a new entity of optic neuropathy. We will review recent advances in pathophysiology, diagnosis, and clinical manifestations of MOG-IgG-associated optic neuritis to better understand its distinctive characteristics. RECENT FINDINGS: MOG is expressed on the surface of myelin sheaths and oligodendrocytes. MOG is highly immunogenic and is a potential target of inflammatory demyelinating disease...
November 2018: Current Opinion in Ophthalmology
Elizabeth Fortin, Dean M Cestari, David H Weinberg
PURPOSE OF REVIEW: Myasthenia gravis is an autoimmune disease that commonly affects the palpebral and extraocular muscles. Ocular myasthenia gravis (OMG) is a variant of the disease that is confined to the ocular muscles but frequently becomes generalized over time. The diagnosis of OMG is often challenging but both clinical and laboratory findings are helpful in confirming the clinical suspicion. This review provides an update on the diagnostic approach and therapeutic options for OMG...
November 2018: Current Opinion in Ophthalmology
Ramana S Moorthy, Meena S Moorthy, Emmett T Cunningham
PURPOSE OF REVIEW: Nearly one-half of all uveitis cases seen at tertiary referral centers have no identifiable cause. Many systemic, paraocular, intraocular, topical medications, and even vaccines can induce intraocular inflammation, scleritis, and rarely orbititis and are often overlooked as causes of uveitis. This review was undertaken to elucidate the strength of association of these medications with uveitis and to make clinicians aware of these associations, especially among newer medications...
November 2018: Current Opinion in Ophthalmology
Nimesh Patel, Nandini Venkateswaran, Ziqi Wang, Anat Galor
PURPOSE OF REVIEW: To provide a review of the potential sight-threatening sequelae associated with ocular involvement of atopic disease and to discuss the management of this chronic condition. RECENT FINDINGS: There has been a recognition that atopic keratoconjunctivitis (AKC) is a chronic, inflammatory and potentially blinding disease. Recent efforts have focused on steroid sparing, systemic T cell and calcineurin inhibitor medications for the treatment of severe disease...
November 2018: Current Opinion in Ophthalmology
Kaidi Wang, Gerami Seitzman, John A Gonzales
PURPOSE OF REVIEW: This review offers recommendations for monitoring disease status in ocular cicatricial pemphigoid as well therapeutic options including local and systemic therapies. RECENT FINDINGS: A negative biopsy on direct immunofluorescence does not preclude a diagnosis of OCP. If a patient's cicatrization is active and/or progressive, systemic immunosuppression should be commenced. SUMMARY: OCP is a chronic systemic autoimmune disease that requires systemic immunosuppression...
November 2018: Current Opinion in Ophthalmology
Bart K Chwalisz, John H Stone
PURPOSE OF REVIEW: IgG4-related disease (IgG4-RD) is increasingly recognized as a fibroinflammatory disease with a plethora of organ-specific manifestations but a particular predilection for head and neck tissues, including the nervous system. This review discusses general features and organ-specific presentations of IgG4-RD as well as treatment considerations, particularly emphasizing features of neuro-ophthalmic interest. RECENT FINDINGS: IgG4-RD is emerging as a common cause of several fibroinflammatory disorders in the head and neck that were previously considered idiopathic, such as sclerosing orbital pseudotumor, orbital myositis, hypophysitis, and hypertrophic pachymeningitis...
November 2018: Current Opinion in Ophthalmology
Gabriela Madriz Peralta, Dean M Cestari
PURPOSE OF REVIEW: We aim to provide a comprehensive and updated review on idiopathic intracranial hypertension (IIH), including the most current studies and treatment options. Special focus will be put on recent theories about the pathophysiology, and on newer prospective studies on treatment modalities. RECENT FINDINGS: The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) provided evidence supporting acetazolamide as a well tolerated first-line therapy in IIH patients with mild vision loss...
November 2018: Current Opinion in Ophthalmology
Wipada Laovirojjanakul, Onsiri Thanathanee
PURPOSE OF REVIEW: The aim of this review is to highlight recent changes in opportunistic ocular infections (OOIs) in the era of modern combination antiretroviral therapy (cART), in the setting of HIV-infected patients. RECENT FINDINGS: Improvements in modern cART has led to a progressive decline in the incidence of OOIs and mortality among patients with AIDS. Not only has there been a decreasing incidence of cytomegalovirus (CMV) retinitis, but there also has been a decline in progression of such retinitis when it does occur in AIDS patients, since the introduction of cART...
November 2018: Current Opinion in Ophthalmology
Aliaa Abdelhakim, Nailyn Rasool
PURPOSE OF REVIEW: Neuroretinitis is an inflammatory disorder of the eye presenting with optic disc edema and the delayed development of a macular star secondary to optic nerve swelling toward the macular structures. Neuroretinitis can be divided into idiopathic, infectious (including neuroretinitis associated with cat scratch disease) and recurrent. RECENT FINDINGS: The clinical presentation of neuroretinitis includes impaired visual acuity, dyschromatopsia, relative afferent pupillary defects and visual field abnormalities - particularly cecocentral and central scotomas...
November 2018: Current Opinion in Ophthalmology
Gurdeep Jhaj, Laura J Kopplin
PURPOSE OF REVIEW: The seronegative spondyloarthropathies are a closely related group of inflammatory diseases that include ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis, inflammatory bowel disease and undifferentiated spondyloarthritis. This review focuses on the spectrum of ocular manifestations associated with these diseases and the current approaches in treating these ocular manifestations. It also highlights the role ophthalmologists can play in identifying and appropriately treating human leukocyte antigen B27 (HLA-B27) associated uveitis and the associated spondyloarthropathies in order to limit ocular and systemic morbidity...
November 2018: Current Opinion in Ophthalmology
Anthony Michael Sammel, Clare Louise Fraser
PURPOSE OF REVIEW: Giant cell arteritis (GCA) is a challenging condition to manage because of the potential for acute irreversible vision loss and corticosteroid-related morbidity. Recent developments offer the potential to improve both the assessment and treatment of patients. RECENT FINDINGS: Vascular imaging is increasingly being used in the diagnostic algorithm for GCA. Results from recent vascular ultrasound and high-resolution cranial MRI studies have led some groups to suggest forgoing temporal artery biopsy (TAB) in selected patients...
November 2018: Current Opinion in Ophthalmology
Zhen Li, Dean M Cestari, Elizabeth Fortin
PURPOSE OF REVIEW: The pathophysiology of thyroid eye disease (TED) is still not fully understood. However, recently described risk factors and molecular findings have brought new insights into the mechanisms of TED and could lead to the emerging use of more targeted therapies. This article aims to review the clinical findings of TED, and the most recent advances in our understanding of the risk factors and therapeutic options for TED. RECENT FINDINGS: Smoking has been recently shown to have an impact on specific gene expression involved in several disease-related pathways, which seems to be reversible with smoking cessation...
November 2018: Current Opinion in Ophthalmology
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