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Ophthalmology and Therapy

Beau J Fenner, Raymond L M Wong, Wai-Ching Lam, Gavin S W Tan, Gemmy C M Cheung
Rising prevalence of diabetes worldwide has necessitated the implementation of population-based diabetic retinopathy (DR) screening programs that can perform retinal imaging and interpretation for extremely large patient cohorts in a rapid and sensitive manner while minimizing inappropriate referrals to retina specialists. While most current screening programs employ mydriatic or nonmydriatic color fundus photography and trained image graders to identify referable DR, new imaging modalities offer significant improvements in diagnostic accuracy, throughput, and affordability...
November 10, 2018: Ophthalmology and Therapy
Reza Moosavi, Ejaz Ansari
INTRODUCTION: To simplify the medical treatment of glaucoma for patients on multiple drops by introducing brinzolamide/brimonidine tartrate fixed combination (BBFC) ophthalmic suspension 1%/0.2% (SIMBRINZA® ; Alcon Laboratories, Inc., Fort Worth, TX, USA) to the drop regimen and to establish its efficacy. To demonstrate that fixed combination (FC) therapies are associated with improvements in treatment adherence and persistence with reduced exposure to preservative-related ocular surface problems...
October 26, 2018: Ophthalmology and Therapy
Daniel C Osborne, Kathryn M Greenhalgh, Megan J E Evans, Jay E Self
INTRODUCTION: Amblyopia therapy appears to be most effective in children under the age of 7 years, but results from randomized control trials (RCTs) have shown that occlusion therapy and/or atropine penalization therapy may improve visual acuity in an older age group. Which of these two therapies is the most effective with fewer adverse effects in an older age group has not yet been agreed upon. METHODS: We systematically searched the literature for RCTs that compared atropine penalization therapy and occlusion therapy in terms of their visual acuity outcomes and adverse events and performed a meta-analysis on the visual acuity data obtained...
October 16, 2018: Ophthalmology and Therapy
Vasileios E Konidaris, Konstantinos T Tsaousis, Rossella Anzidei, Guillermo de la Mata, Alexander J Brent
INTRODUCTION: To investigate treatment outcomes after switching from ranibizumab to aflibercept intravitreal injections in patients with macular oedema (MO) secondary to branch retinal vein occlusion (BRVO). METHODS: Eligible patients with refractory MO secondary to BRVO, post treatment with a minimum of three intravitreal injections of ranibizumab at 4-weekly intervals were recruited. Suboptimal or non-responders were defined as patients who had persistent intraretinal fluid (< 75% decrease from baseline) despite a minimum of three consecutive injections...
October 4, 2018: Ophthalmology and Therapy
Majid Moshirfar, Tanner W Brown, Jackson L Goldberg, William D Wagner, Yasmyne C Ronquillo
Currently, there are no specific guidelines in place to direct eye banks on how to deal with donated tissue from transgender individuals. This commentary will examine the history of corneal transplantation and the importance of the corneal tissue donor. In doing so, the donor selection criteria established by the Food and Drug Administration will be presented. Additionally, the history of blood donor deferral policies created for men who have sex with men and how those policies have changed over time will be explored...
September 26, 2018: Ophthalmology and Therapy
Susmito Biswas, Martha Gaviria, Luísa Malheiro, João Pedro Marques, Vincenzo Giordano, Hong Liang
Cystinosis, a rare autosomal recessive disease caused by intracellular cystine accumulation, occurs in an estimated 1/100,000-200,000 live births. Ocular non-nephropathic cystinosis is typically diagnosed during adulthood, when patients present with corneal crystal deposition and no systemic involvement. Due to the rarity of the condition, diagnosis is often delayed and can have a significant impact on the overall prognosis of the disease. Early diagnosis is therefore imperative to ensure successful treatment and improve quality of life, as most of its clinical manifestations can be prevented or delayed...
September 21, 2018: Ophthalmology and Therapy
Mashaer O Fallatah
INTRODUCTION: Diabetes mellitus (DM) is common metabolic disorder that is characterized by increased circulating blood glucose levels. Long-term, continuous hyperglycemia leads to vasculature-related disorders, including those affecting the eyes, such as retinopathy. The objective of this study was to assess the awareness of diabetic complications, specifically diabetic retinopathy, among diabetic patients attending the Jeddah Eye Hospital. METHODS: This was a cross-sectional study targeting the outpatient clinics of Jeddah Eye Hospital for a period of 2 months...
September 19, 2018: Ophthalmology and Therapy
William Fusi-Rubiano, Rebecca R Blow, Mark Lane, Rupal Morjaria, Alastair K Denniston
Diabetic macular edema (DMO) is a leading cause of blindness in the working age population. Although anti-vascular endothelial growth factor (VEGF) therapy provided a major advance in treatment of DMO for many patients, there is a significant proportion of patients who maintain persistent DMO and have minimal response to anti-VEGF treatment. Iluvien (fluocinolone acetonide 0.19 mg [FAc]) is an important additional treatment option for DMO. In this review we describe the clinical context and the evidence for the use of the FAc implant in treating DMO, from pilot to randomized controlled studies, to later phase real world data...
September 18, 2018: Ophthalmology and Therapy
Nikolaos Kozeis, Magdalini Triantafylla, Aspasia Adamopoulou, Stergiani Veliki, Athina Kozei, Straton Tyradellis
INTRODUCTION: A lot of different techniques have been proposed in order to manage abduction limitation secondary to sixth nerve palsy; however, anterior segment ischemia remains a concern. The aim of this study was to evaluate the results of augmented vertical recti muscle transposition (VRT) with partial recession of medial rectus muscle (MR) for complete, chronic sixth nerve palsy, a new modified technique that could also minimize the risk for anterior segment ischemia (ASI). METHODS: In this nonrandomized 8-year (2009-2017) retrospective review, 20 patients with complete sixth nerve palsy and contracted MR were enrolled...
September 8, 2018: Ophthalmology and Therapy
Eleftherios Loukovitis, Konstantinos Sfakianakis, Panagiota Syrmakesi, Eleni Tsotridou, Myrsini Orfanidou, Dimitra Rafailia Bakaloudi, Maria Stoila, Athina Kozei, Spyridon Koronis, Zachos Zachariadis, Paris Tranos, Nikos Kozeis, Miltos Balidis, Zisis Gatzioufas, Aliki Fiska, George Anogeianakis
INTRODUCTION: Keratoconus (KC) is a complex, genetically heterogeneous, multifactorial degenerative disorder that is accompanied by corneal ectasia which usually progresses asymmetrically. With an incidence of approximately 1 per 2000 and 2 cases per 100,000 population presenting annually, KC follows an autosomal recessive or dominant pattern of inheritance and is, apparently, associated with genes that interact with environmental, genetic, and/or other factors. This is an important consideration in refractive surgery in the case of familial KC, given the association of KC with other genetic disorders and the imbalance between dizygotic twins...
September 6, 2018: Ophthalmology and Therapy
Nirmal R Gosalia, Mark S Dikopf, Jennifer I Lim, Amy Y Lin, Elmer Y Tu, Ahmad A Aref
INTRODUCTION: To present a case of an epithelial inclusion cyst masquerading as an inadvertent bleb in a patient with Marfan syndrome. CASE REPORT: A woman with Marfan syndrome presented with a subluxed crystalline lens in her right eye, which progressively subluxed over the following 2 years. A lensectomy was performed with placement of an anterior chamber intraocular lens (IOL); however, the patient experienced blurred vision and photopsias and preferred IOL explantation...
August 16, 2018: Ophthalmology and Therapy
Penny A Asbell, Rahul T Pandit, Christine M Sanfilippo
INTRODUCTION: The Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) study is an ongoing nationwide surveillance program that surveys in vitro antibiotic resistance rates and trends among ocular bacterial pathogens. We report resistance rates by geographic region for isolates collected from 2009 through 2016. METHODS: Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa isolates from ocular infections were collected at clinical centers across the US and categorized by geographic region based on state...
August 9, 2018: Ophthalmology and Therapy
Maria Vittoria Cicinelli, Alessandro Marchese, Francesco Bandello, Giulio Modorati
Ocular surface squamous neoplasia (OSSN) is the most common non-pigmented malignancy of the ocular surface and is represented in a wide range of histologic diagnoses, ranging from mild epithelial dysplasia to invasive squamous carcinoma. Although surgical excision is still the gold standard for OSSN treatment, interest in conservative medical approaches is steadily growing. We have reviewed all of the literature on OSSN published in English in the MEDLINE database up to May 2018, using the keywords "ocular surface squamous neoplasia," "squamous conjunctival carcinoma," and "conjunctival carcinoma in situ," with the aim to provide a comprehensive review of the most recent evidence on this distinct clinical entity...
July 20, 2018: Ophthalmology and Therapy
Maria Eleftheriadou, Maria Gemenetzi, Marko Lukic, Sobha Sivaprasad, Philip G Hykin, Robin D Hamilton, Ranjan Rajendram, Adnan Tufail, Praveen J Patel
INTRODUCTION: To report 3-year treatment outcomes with intravitreal aflibercept injections for neovascular age-related macular degeneration (nAMD) in routine clinical practice. METHODS: This was a retrospective, single-centre, non-randomized interventional case series analysis. Data from treatment-naïve patients with nAMD treated between 1 October 2013 and 31 February 2014 were included in the analysis. Data including age, gender, vision acuity (VA) measured on Early Treatment of Diabetic Retinopathy Study charts (ETDRS) and injection numbers were recorded...
July 7, 2018: Ophthalmology and Therapy
Nicholas K George, Michael W Stewart
Post-operative endophthalmitis (POE) following cataract surgery is an uncommon, vision-threatening complication that has been reported to occur at rates of between approximately 0.03% and 0.2%. Prompt diagnosis and treatment of endophthalmitis is critical for minimizing vision loss, but most recent efforts have focused on the prophylactic administration of antibiotics to prevent the development of endophthalmitis. Surgeons from around the world have different topical and intracameral antibiotic usage patterns to prevent endophthalmitis, and to date no general consensus regarding best practice has emerged...
July 5, 2018: Ophthalmology and Therapy
Majid Moshirfar, Michael S Murri, Tirth J Shah, Steven H Linn, Yasmyne Ronquillo, Orry C Birdsong, Phillips C Hoopes
INTRODUCTION: The primary objective was to show our initial surgical single-site experience with small incision lenticule extraction (SMILE) after the official enrollment in March 2017 following Food and Drug Administration (FDA) approval for simple myopia in late 2016 in the United States and, subsequently, compare our results to the earliest and most advanced generation of excimer platforms for laser-assisted in situ keratomileusis (LASIK) surgery. METHODS: This was a retrospective single-site study of 68 eyes from 35 patients who had SMILE surgery...
June 29, 2018: Ophthalmology and Therapy
Tirth J Shah, Majid Moshirfar, Phillip C Hoopes
Our purpose is to present an evidence-based approach, directed primarily towards eye-care specialists, clarifying whether certain drugs should or should not be used in patients with sulfonamide allergy. We conducted a literature search using PubMed to identify the risk of ophthalmic-specific drugs in patients with a self-reported sulfonamide allergy. MeSH key words included "sulfonamide" and "hypersensitivity". Articles specifically geared towards ophthalmic diseases were sought. The evidence illustrates that individuals with sulfonamide allergy are intrinsically predisposed to higher rates of allergic reaction that is not specific towards sulfonamide non-antimicrobials or sulfur-based medications...
June 29, 2018: Ophthalmology and Therapy
Philip Bloom, Leon Au
Surgical treatment for glaucoma has undergone a dramatic change over the last decade. Trabeculectomy has been the main surgical procedure worldwide for almost 50 years. However, there is a growth in development of new novel devices and surgical techniques designed to lower intraocular pressure in a less invasive fashion. The term minimally invasive glaucoma surgery (MIGS) has been coined and is the subject of investment, debate and, increasingly, research. The position of MIGS in the glaucoma treatment paradigm is yet to be clearly defined and its ability to replace conventional filtration surgery remains debatable...
June 22, 2018: Ophthalmology and Therapy
Ramón Ruiz Mesa, Tiago Monteiro
Presbyopia is a condition that affects many as the lens ages, and is a secondary effect of cataract surgery. Multifocal lenses for the treatment of presbyopia have been undergoing cycles of development and improvement over the past two decades. The latest advancements have yielded lenses with a continuous range of optical powers, otherwise known as continuous transitional focus (CTF) lenses. Modern CTF lenses provide a more natural experience for patients while minimizing unwanted optical side effects.
June 18, 2018: Ophthalmology and Therapy
Andrea Giudiceandrea, Maria Emanuela Toro, Andrea Scupola, Aldo Caporossi, Viviana Nociti, Massimiliano Mirabella, Tommaso Salgarello
INTRODUCTION: The purpose of this case series was to report the potential role of cyclophosphamide (CY) on bleb survival and to evaluate the safety of the trabeculectomy procedure under immunosuppressant systemic therapy. CASE SERIES: Five eyes of five patients with unresponsive to intraocular pressure (IOP) lowering medication, progressive glaucoma, underwent mytomicin C (MMC) augmented phaco-trabeculectomy, performed by the same surgeon, A.G., during the period from May 2015 to January 2016...
June 7, 2018: Ophthalmology and Therapy
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