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Opthalmology

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195 papers 500 to 1000 followers Essential read and updates
By Yasir Imam Trainee in opthalmology with interest in vitreoretinal diseases
https://www.readbyqxmd.com/read/28942074/immunosuppression-for-the-uveitides
#1
REVIEW
Douglas A Jabs
The uveitides are a collection of more than 30 diseases characterized by intraocular inflammation. Many cases of juvenile idiopathic arthritis-associated uveitis, many cases of intermediate uveitis, and most cases of posterior and panuveitides requiring treatment are treated with corticosteroids and immunosuppression. Disease-specific, time-updated modeling of clinical data for several uveitides suggests superior prevention of ocular complications and visual outcomes with immunosuppression. These studies also suggest that oral corticosteroids at doses low enough for safe long-term therapy (i...
September 20, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28942073/update-on-the-management-of-infectious-keratitis
#2
REVIEW
Ariana Austin, Tom Lietman, Jennifer Rose-Nussbaumer
Infectious keratitis is a major global cause of visual impairment and blindness, often affecting marginalized populations. Proper diagnosis of the causative organism is critical, and although culture remains the prevailing diagnostic tool, newer techniques such as in vivo confocal microscopy are helpful for diagnosing fungus and Acanthamoeba. Next-generation sequencing holds the potential for early and accurate diagnosis even for organisms that are difficult to culture by conventional methods. Topical antibiotics remain the best treatment for bacterial keratitis, and a recent review found all commonly prescribed topical antibiotics to be equally effective...
November 2017: Ophthalmology
https://www.readbyqxmd.com/read/28951074/accuracy-of-intraocular-lens-calculation-formulas
#3
Ronald B Melles, Jack T Holladay, William J Chang
PURPOSE: To compare the accuracy of intraocular lens (IOL) calculation formulas (Barrett Universal II, Haigis, Hoffer Q, Holladay 1, Holladay 2, Olsen, and SRK/T) in the prediction of postoperative refraction using a single optical biometry device. DESIGN: Retrospective consecutive case series. PARTICIPANTS: A total of 13 301 cataract operations with an AcrySof SN60WF implant and 5200 operations with a SA60AT implant (Alcon Laboratories, Inc...
September 23, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28755306/keratoconus-treatment-algorithm
#4
REVIEW
Konstantinos D Andreanos, Kate Hashemi, Myrsini Petrelli, Konstantinos Droutsas, Ilias Georgalas, George D Kymionis
Keratoconus management has significantly changed over the last two decades. The advent of new interventions such as cornea cross-linking, intrastromal corneal ring segments, and combined treatments provide corneal clinicians a variety of treatment options for the visual rehabilitation of keratoconus patients. This review summarizes current evidence for these treatments and highlights their place in keratoconus management while new promising emerging therapies are being investigated.
December 2017: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/28655539/myopic-choroidal-neovascularization-review-guidance-and-consensus-statement-on-management
#5
REVIEW
Chui Ming Gemmy Cheung, Jennifer J Arnold, Frank G Holz, Kyu Hyung Park, Timothy Y Y Lai, Michael Larsen, Paul Mitchell, Kyoko Ohno-Matsui, Shih-Jen Chen, Sebastian Wolf, Tien Yin Wong
TOPIC: The aim of this article is to review and compile available information on the classification, pathophysiology, and clinical features of myopic choroidal neovascularization (CNV); to describe the latest data on the management of this disease; and to present guidance. CLINICAL RELEVANCE: In the United States, myopia affects approximately 34 million people (2010), and similar figures have been reported in Europe. Pathologic myopia (PM), a possible consequence of myopia, is estimated to affect up to 3% of the global population...
November 2017: Ophthalmology
https://www.readbyqxmd.com/read/28435217/patient-selection-for-corneal-collagen-cross-linking-an-updated-review
#6
REVIEW
Virgilio Galvis, Alejandro Tello, Alvaro I Ortiz, Luis C Escaf
Corneal cross-linking (CXL) is an option that in the last decade has demonstrated its efficacy and safety in halting the progression of keratoconus (KCN) and other corneal ectasias. Its indication has been extended beyond the classic definition that required evidence of KCN progression, especially in the presence of some risk factors for a possible progression (particularly the younger age). However, the results can be still somewhat variable today. There are several protocols, each with its own advantages and disadvantages...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28258400/a-review-of-selective-laser-trabeculoplasty-recent-findings-and-current-perspectives
#7
REVIEW
Yujia Zhou, Ahmad A Aref
Selective laser trabeculoplasty (SLT) has been widely used in the clinical management of glaucoma, both as primary and adjunctive treatment. As new evidence continues to arise, we review the current literature in terms of indications and efficacy, surgical technique, postoperative care, repeatability, and complications of this therapy. SLT has been shown to be effective in various glaucomas, including primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), steroid-induced glaucoma, pseudoexfoliation glaucoma (PXFG), and primary angle-closure glaucoma (PACG), as well as other glaucoma subtypes...
June 2017: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/28110952/outbreak-of-subacute-onset-toxic-anterior-segment-syndrome-associated-with-single-piece-acrylic-intraocular-lenses
#8
MULTICENTER STUDY
Tetsuro Oshika, Shuichiro Eguchi, Hiroshi Goto, Yuichi Ohashi
PURPOSE: To report the results of a clinical investigation after an outbreak of subacute-onset toxic anterior segment syndrome (TASS) after implantation of single-piece acrylic intraocular lenses (IOLs), which then were recalled voluntarily from the market. DESIGN: Retrospective, multicenter, observational case series. PARTICIPANTS: Cases reported to the manufacturer from January 2015 through March 2016 of unusual ocular inflammation after cataract surgery using AcrySof ReSTOR, ReSTOR toric, or AcrySof IQ toric SN6AT6-9 IOLs (Alcon Laboratories, Inc...
April 2017: Ophthalmology
https://www.readbyqxmd.com/read/27913439/retinitis-pigmentosa-associated-cystoid-macular-oedema-pathogenesis-and-avenues-of-intervention
#9
REVIEW
S Strong, G Liew, M Michaelides
Hereditary retinal diseases are now the leading cause of blindness certification in the working age population (age 16-64 years) in England and Wales, of which retinitis pigmentosa (RP) is the most common disorder. RP may be complicated by cystoid macular oedema (CMO), causing a reduction of central vision. The underlying pathogenesis of RP-associated CMO (RP-CMO) remains uncertain, however, several mechanisms have been proposed, including: (1) breakdown of the blood-retinal barrier, (2) failure (or dysfunction) of the pumping mechanism in the retinal pigment epithelial, (3) Müller cell oedema and dysfunction, (4) antiretinal antibodies and (5) vitreous traction...
January 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/25985434/vitamin-d-in-multiple-sclerosis-and-central-nervous-system-demyelinating-disease-a-review
#10
REVIEW
Jodie M Burton, Fiona E Costello
BACKGROUND: The role of vitamin D as both a risk factor and a disease modifier in multiple sclerosis (MS) has a storied history with ongoing accumulation of supportive convergent evidence from animal data, clinical studies and trials, and biomarkers of disease. EVIDENCE ACQUISITION: A detailed review of the published literature ranging from in vivo immune studies to human clinical studies of epidemiology, physiology, immunology, clinical, and radiological markers was undertaken...
June 2015: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/27625747/treatment-of-diabetic-retinopathy-recent-advances-and-unresolved-challenges
#11
REVIEW
Michael W Stewart
Diabetic retinopathy (DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered. The global diabetes epidemic threatens to overwhelm resources and increase the incidence of blindness, necessitating the development of innovative programs to diagnose and treat patients. The introduction and rapid adoption of intravitreal pharmacologic agents, particularly drugs that block the actions of vascular endothelial growth factor (VEGF) and corticosteroids, have changed the goal of DR treatment from stabilization of vision to improvement...
August 25, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/27720552/aqueous-chlorhexidine-for-intravitreal-injection-antisepsis-a-case-series-and-review-of-the-literature
#12
REVIEW
Rohan Merani, Zachary E McPherson, Alan P Luckie, Jagjit S Gilhotra, Jim Runciman, Shane Durkin, James Muecke, Mark Donaldson, Albert Aralar, Anupam Rao, Peter E Davies
PURPOSE: To determine the incidence of endophthalmitis in a large clinical series using aqueous chlorhexidine for antisepsis before intravitreal injection and to review the ophthalmic literature regarding chlorhexidine efficacy and safety. DESIGN: Multicenter retrospective case series. PARTICIPANTS: All patients receiving intravitreal injections from 7 retinal specialists. METHODS: An audit of intravitreal injections performed by retinal specialists who exclusively used aqueous chlorhexidine 0...
December 2016: Ophthalmology
https://www.readbyqxmd.com/read/27626157/normal-tension-glaucoma-an-update
#13
REVIEW
Bruno Leonardo Barranco Esporcatte, Ivan Maynart Tavares
Normal-tension glaucoma (NTG) is a progressive optic neuropathy with intraocular pressure (IOP) within the statistically normal range (≤21 mmHg). The prevalence of NTG varies widely among different population studies, being the most prevalent open-angle glaucoma subtype in some reports. The etiology of NTG possibly is multifactorial and still not well defined. Alternative treatments have been proposed based on pathogenesis details. However, in clinical practice, adequate reduction of IOP remains the keystone of managing patients with NTG...
July 2016: Arquivos Brasileiros de Oftalmologia
https://www.readbyqxmd.com/read/27484365/strategies-for-improving-patient-comfort-during-intravitreal-injections-results-from-a-survey-based-study
#14
Jessica Gomez, Dara D Koozekanani, Alex Z Feng, Mitchell Holt, Paul Drayna, Melissa R Mackley, Frederik J G M van Kuijk, Robert M Beardsley, Richard H Johnston, Joseph M Terry, Sandra R Montezuma
INTRODUCTION: Many ocular diseases require intravitreal injections of pharmacological agents. Optimizing patients' experiences during injections is important to ensure compliance and maintenance of quality of life. The objective of this study was to identify strategies to help alleviate discomfort during intravitreal injections. METHODS: A cross-sectional study surveying 128 patients during clinic visits between 2014 and 2015 in two outpatient Retina Clinics (one academic and one private)...
December 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/27192988/electronic-patient-records-to-identify-patients-in-the-united-kingdom-with-diabetic-macular-oedema-suitable-for-iluvien-%C3%A2-fluocinolone-acetonide
#15
Farhat Butt, Kamron Khan, Saadia Chaudhry, Rehna Khan
INTRODUCTION: We describe a proactive method using electronic patient records (EPR) to identify pseudophakic patients with diabetic macular oedema (DMO) that might benefit from treatment with 0.2 µg/day fluocinolone acetonide (FAc; ILUVIEN(®)) implant. METHODS: Our EPR audit tool (Medisoft(®)) identified diabetic patients (May 2011-December 2014) with National Screening Committee-confirmed grade M1 maculopathy. Searches segmented this DMO patient population into patient groups who: (1) had received ranibizumab therapy, (2) had received ≥2 macular laser treatments, or (3) were unsuitable for macular laser or ranibizumab therapy...
June 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/27164896/elevated-intraocular-pressure-after-intravitreal-steroid-injection-in-diabetic-macular-edema-monitoring-and-management
#16
Francisco J Goñi, Ingeborg Stalmans, Philippe Denis, Jean-Philippe Nordmann, Simon Taylor, Michael Diestelhorst, Antonio R Figueiredo, David F Garway-Heath
INTRODUCTION: With the increasing use of intravitreal administration of corticosteroids in macular edema, steroid-induced intraocular pressure (IOP) rise is becoming an emergent issue. However, for patients in whom intravitreal steroids are indicated, there are no specific recommendations for IOP monitoring and management after intravitreal administration of corticosteroids. METHOD: An expert panel of European ophthalmologists reviewed evidence on corticosteroid-induced IOP elevation...
June 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/27014390/managing-primary-angle-closure-glaucoma-the-role-of-lens-extraction-in-this-era
#17
Nafees Baig, Ka-Wai Kam, Clement C Y Tham
Trabeculectomy has been the gold standard in reducing intraocular pressure (IOP) in glaucoma patients, no matter it is angle closure or open angle glaucoma. However in primary angle closure glaucoma, no matter the lens is cataractous or not, it is likely to be pathological, this thicker than usual lens, with or without a more anterior position, is often regarded as a strong contributing factor to angle closure. Lens extraction, no matter it is cataractous or clear, can theoretically eliminate this anatomical predisposing factor of angle closure, and thus IOP can be reduced...
2016: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/26693725/nd-yag-laser-hyaloidotomy-for-the-treatment-of-acute-subhyaloid-hemorrhage-a-comparison-of-two-cases
#18
Jens Heichel, Elisabeth Kuehn, Astrid Eichhorst, Thomas Hammer, Iris Winter
INTRODUCTION: Subhyaloid hemorrhage, whether spontaneous or in the context of a Valsalva maneuver, can lead to an acute decrease in vision when located in the premacular region. Nd:YAG laser hyaloidotomy (NYLH) is a minimally invasive treatment option. METHODS: We examined two different clinical courses based on two case reports of NYLH. One case report described a 52-year-old female patient who presented with a painless decrease of vision to 20/200. The fundoscopy verified a subhyaloid premacular hemorrhage...
June 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/26885863/case-series-investigating-the-efficacy-and-safety-of-bilateral-fluocinolone-acetonide-iluvien-%C3%A2-in-patients-with-diabetic-macular-edema
#19
Ibrahim Elaraoud, Alaa Attawan, Fahd Quhill
INTRODUCTION: Patients with diabetic macular edema (DME), a chronic, vision-limiting condition, may be insufficiently responsive to standard-of-care anti-vascular endothelial growth factor (VEGF) and/or laser therapies. One approved treatment for such patients is 0.2 μg/day fluocinolone acetonide (FAc) sustained-release implant; however, data are limited for treatment strategies in patients with bilateral chronic DME insufficiently responsive to standard-of-care therapies. METHODS: Six pseudophakic patients with bilateral, chronic DME previously treated with laser and anti-VEGF therapy (and intravitreal triamcinolone acetonide in 10 eyes) were retrospectively investigated for visual and anatomical outcomes, 6 months post-0...
June 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/26992838/recommendations-on-screening-for-chloroquine-and-hydroxychloroquine-retinopathy-2016-revision
#20
Michael F Marmor, Ulrich Kellner, Timothy Y Y Lai, Ronald B Melles, William F Mieler
BACKGROUND: The American Academy of Ophthalmology recommendations on screening for chloroquine (CQ) and hydroxychloroquine (HCQ) retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. PATTERN OF RETINOPATHY: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. DOSE: We recommend a maximum daily HCQ use of ≤5...
June 2016: Ophthalmology
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