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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...
September 14, 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...
September 14, 2018: Current Opinion in Ophthalmology
Kaidi Wang, Gerami Seitzman, John 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...
September 14, 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...
September 7, 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...
August 29, 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...
August 29, 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...
August 24, 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...
August 24, 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...
August 22, 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...
August 18, 2018: Current Opinion in Ophthalmology
Dawn Mabra, Steven Yeh, Jessica G Shantha
PURPOSE OF REVIEW: To review the systemic and ocular complications of Bartonella spp. infections specifically cat scratch disease, encompassing epidemiology, laboratory diagnostics, ophthalmic imagining, and treatment. RECENT FINDINGS: Recent studies have shown that ocular manifestations occur in approximately 4.4% of cat scratch disease patients. The annual prevalence is lower than previously reported to be approximately 12 500 cases annually. Mainstay treatment continues to be oral antibiotics with and without corticosteroids and is dependent on associated systemic manifestations, age, and patient immune status...
August 18, 2018: Current Opinion in Ophthalmology
Tracy J Lu, Dean M Cestari
PURPOSE OF REVIEW: Neuro-ophthalmic imaging is an invaluable tool for clinical decision-making and has evolved rapidly. At the same time, both imaging utilization and healthcare costs have skyrocketed, and concern for imaging overuse has become a salient topic. This article gives an overview of the current state of neuro-ophthalmic imaging from a value-based medicine lens and discusses recent neuro-ophthalmic advancements in OCT with these considerations in mind. RECENT FINDINGS: Neuro-ophthalmology is not immune to the waste prevalent in medical imaging...
August 18, 2018: Current Opinion in Ophthalmology
Sharon S Lehman, Judith B Lavrich
PURPOSE OF REVIEW: Pediatric optic neuritis may be challenging to diagnose and treat. Significant clinical investigation of optic neuritis occurring in adults guides current clinical practices. Differences in presentation and prognosis exist for pediatric patients with optic neuritis when compared with adults including the risk of developing multiple sclerosis. The aim of this review is to provide an update on latest advances in the diagnosis, treatment and current research concerning pediatric optic neuritis...
September 2018: Current Opinion in Ophthalmology
Daniel T Weaver
PURPOSE OF REVIEW: Blepharoptosis is a common problem encountered in the pediatric ophthalmology clinic. The presentation is obvious to both parents and referring physicians and often prompts urgent consultation. The current classification and management of childhood ptosis will be reviewed. RECENT FINDINGS: Recent refinements in techniques utilizing new materials hold promise for better, more predictable outcomes and improved long-term results. Autogenous tensor tendon fascia lata harvested from the patient's thigh remains the gold standard for many ptosis surgeons in frontalis suspension; however, other materials are commonly utilized, including silicone rod, Gore-Tex (ePTFE; W...
September 2018: Current Opinion in Ophthalmology
Avrey Thau, Maureen Lloyd, Sharon Freedman, Allen Beck, Alana Grajewski, Alex V Levin
PURPOSE OF REVIEW: The Childhood Glaucoma Research Network (CGRN) has created a new classification system for childhood glaucoma that has become the first International Consensus Classification. The purpose of this review is to present this classification system and share its use to date. RECENT FINDINGS: The diagnoses of the classification system include glaucoma and glaucoma suspect. The primary glaucomas include: primary congenital glaucoma and juvenile open-angle glaucoma...
September 2018: Current Opinion in Ophthalmology
Michael J Bartiss
PURPOSE OF REVIEW: As the population ages, the number of patients presenting to ophthalmologists with complaints of double vision is increasing. RECENT FINDINGS: Diplopia is known to occur for optical, neuroophthalmological, strabismological and even iatrogenic reasons following various ophthalmic surgical procedures. The mainstays of the nonsurgical treatment of diplopia including no treatment, partial or total occlusion, press-on or ground in prisms and vergence exercises (to increase fusional vergence amplitudes) have been utilized for some time...
September 2018: Current Opinion in Ophthalmology
Judith B Lavrich
No abstract text is available yet for this article.
September 2018: Current Opinion in Ophthalmology
Ahmet Kaan Gündüz, Yağmur Seda Yeşiltaş, Carol L Shields
PURPOSE OF REVIEW: The goal of this article is to review the key clinical and radiological features, treatment strategies, and prognosis of lacrimal gland tumors. RECENT FINDINGS: Debulking of the orbital lobe of the lacrimal gland may offer improved control rates in dacryoadenitis without compromise of tear film function. Contrary to previous belief, careful biopsy of the lacrimal gland prior to excision does not appear to increase the risk of recurrence in cases with suspected pleomorphic adenoma...
September 2018: Current Opinion in Ophthalmology
Lynn H Trieu, Judith B Lavrich
PURPOSE OF REVIEW: As the majority of our patients are spending significant time using computers and reading, it is important to understand any disease process that can affect one's near vision. Convergence insufficiency, not an uncommon condition, is still not screened for by most eyecare professionals. This review aims to report the current screening methods and diagnostic criteria, and to summarize the current treatment of convergence insufficiency. RECENT FINDINGS: The current literature shows that convergence insufficiency has a prevalence of 2-17% in the general population and an even higher rate, up to 49%, in patients who have suffered a traumatic brain injury...
September 2018: Current Opinion in Ophthalmology
Suzanne W van Landingham, Jacqueline Diels, Mark J Lucarelli
PURPOSE OF REVIEW: The aim of this study was to describe the current state of physical therapy for facial nerve palsy, the evidence basis for these interventions and how therapy can be integrated with other medical and surgical interventions for facial nerve palsy, as it applies to ophthalmologists, oculoplastic surgeons and other specialists. RECENT FINDINGS: Many studies indicate that physical therapy is effective for the rehabilitation of patients with facial nerve palsy and can be used synergistically with interventions administered by physicians, such as targeted botulinum toxin injections...
September 2018: Current Opinion in Ophthalmology
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