Current Trends in Ophthalmology最新文献

{"title":"Associations of hypertension Diabetes Smoking History and SNPs with Responses to Aflibercept Treatment for tAMD and PCV","authors":"Koji Kariya-city Aichi-pref. Tanaka, Koichi Furuya, R. Mori, A. Kawamura, M. Yuzawa, S. Yamagami","doi":"10.18314/CTOY.V2I1.1666","DOIUrl":"https://doi.org/10.18314/CTOY.V2I1.1666","url":null,"abstract":"Purpose: To determine the correlation between therapeutic effects of IVA treatment on typical AMD (tAMD), and polypoidal choroidal vasculopathy (PCV) and the history of hypertension, diabetes mellitus, smoking history and single nucleotide polymorphisms (SNPs).Methods: Prospective, interventional study. Subjects were assigned to 125 untreated patients with exudative AMD (tAMD: 58 patients, PCV: 67 patients, male: 91:34, mean age 73.4 years). Among the tAMD patients, there were 28 bimonthly injections 30 who received pro re nata (PRN) injections after three monthly injections. Among the PCV patients, 33 were treated with bimonthly injections and 34 received PRN injections after three monthly injections. Therapeutic effects were evaluated by best-corrected visual acuity (BCVA), central retinal thickness (CRT), subfoveal choroidal thickness (CCT), and exudative change after 3 months and 1 year from initial treatment, and also the history of hypertension, diabetes mellitus, smoking and five SNPs (rs10490924, rs800292, rs699947, rs1061170, rs13278062).Results: Improvements of BCVA, CRT were observed in all groups at 1 year after initial treatment. The one-yearchange in CRT showed significant improvement in nonsmokers than smokers in tAMD. The one-year change in CRT indicated a significant improvement in non-diabetic patients in PCV. There was more exudation at both 3 months and 1 year who had smoking history in tAMD. With respect to the rs1061170 mutation of tAMD, in the case with TT type, significant residual exudation was noted at both 3 and 12 months.Conclusions: The history of smoking and diabetes could be influence to IVA treatment for AMD.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126779710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive Antifibrotic Therapy with Mitomycin C and 5-Fluorouracil: A Review of their use in Glaucoma Surgery and Considerations around Ophthalmic Compounding","authors":"R. Fiscella, Leiter Cw, F Massoomi, R. Noecker, A. Sheybani","doi":"10.18314/CTOY.V2I1.1670","DOIUrl":"https://doi.org/10.18314/CTOY.V2I1.1670","url":null,"abstract":"Background: Antifibrotics and antimetabolites, including 5-fluorouracil (5-FU) and mitomycin C (MMC), have been used for decades to improve ophthalmic surgical outcomes, most notably with glaucoma filtering procedures. Adjuvant MMC and 5-FU also enhance the efficacy of minimally invasive subconjunctival drainage implants now being used. The authors feel that a review of the usage and safety of these agents is merited, especially in light of updated and new USP guidelines for compounded and hazardous drugs.Main Body: The mode of perioperative administration of MMC during glaucoma surgery is evolving with a shift from the traditional sponge application to subconjunctival injection, allowing for a more precise dosing and controlled administration of this medication. Several studies demonstrate effective use of MMC and 5-FU, at a variety of different doses. Most of these studies use compounded MMC and 5-FU. Glaucoma surgeons must be careful in how they source MMC, however, as the U.S. Food & Drug Administration (FDA) expects physicians to use FDA-approved drug products when clinically appropriate. When a physician determines a compounded version of MMC is clinically necessary for an individual patient, the FDA closely regulates how and when drug products can be compounded and by what type of facilities. There will also be additional increased scrutiny on storage and disposal of MMC and 5-FU as new regulations are introduced.Conclusion: This review of MMC and 5-FU and their role in glaucoma surgery will address questions regarding drug safety, procurement, use, and disposal.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121589850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Periorbital Necrotising Fasciitis Utilising Negative Pressure Wound Therapy: A Case Report","authors":"Anna M Waldie, Fiona S. Lau, Jenny L. Hepschke, I. Francis, G. Wilcsek","doi":"10.18314/CTOY.V2I1.1565","DOIUrl":"https://doi.org/10.18314/CTOY.V2I1.1565","url":null,"abstract":"Necrotising fasciitis is a fulminant, rapidly progressive infection associated with extensive tissue destruction and significant mortality. Given the robust blood supply of the face, periorbital necrotising fasciitis is rare in this region. Traditional management consists of prompt initiation of antibiotics and adequate surgical debridement. This report documents the outcome of Type 2 periorbital necrotising fasciitis in a 49-year-old, immunocompetent man, in whom negative pressure wound therapy, was combined with conventional measures. The negative pressure wound therapy was applied directly to the involved orbit, suggesting its safety and efficacy in relation to use over the orbit. Negative pressure wound therapy may be a useful adjunct to the armamentarium of the oculoplastic surgeon for the reconstruction of periorbital defects produced by the surgical debridement of periorbital necrotising fasciitis.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130357335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foveal Avascular Zone in Hypertension as Measured by Optical Coherence Tomography Angiography","authors":"Ludmila Gomes Dantas De Sá, D. Gadelha, Maria Cecília Santos Cavalcanti Melo, C. Brandt","doi":"10.18314/CTOY.V2I1.1604","DOIUrl":"https://doi.org/10.18314/CTOY.V2I1.1604","url":null,"abstract":"Purpose: To investigate the Foveal Avascular Zone (FAZ) area in patients with arterial hypertension using optical coherence tomography angiography (OCT-A).Material and methods: The study was permormed at the School Clinic of UNIFACISA and at the Eye Care Center. It was included 21 hypertensive patients (study group) and 19 individuals without hypertension (control group). It was excluded patientes with diabetes or glaucoma. The measurement of the FAZ areas was performed by the DRI OCT-1Triton/Plus. For the quantitative variables, the results were expressed by their means and standard deviations. Qualitative variables were expressed by their absolute and relative frequencies. Student’s t-test was used to verify differences between means and Fisher’s exact test for differences between frequencies. For evaluating the correlation between the superficial and deep plexus areas, the Pearson correlation test was used. P value ≤ 0.05, rejected the null hypothesis. The research was approved by the Ethics Committee of the Medical School from Campina Grande -UNIFACISA and all individuals signed the free and informed consent form.Results: The means of the superficial FAZ of both eyes was significantly higher in the study group (right eye 410.7 ± 160.7 μm2 - 319.1 ± 108.2 μm2 - p = 0.0433); (left eye: 405.4 ± 144.8 μm2 versus 309.4 ± 87.7 μm2- p = 0.0174). The means of the deep FAZ areas of the right and left eyes were similar between the study and control groups (right eye: 559.6 ± 253.28 μm2 versus 605.1 ± 226.8 μm2 - p = 0.5548); (left eye: 673.2 ± 170.8 μm2 versus 585.6 ± 171.2 μm2 - p = 0.1142). The relationships between the superficial and deep plexus areas of both eyes showed a weak correlation between the two plexuses. (r = 0.4734), left eye (r = 0.2287), study group - right eye: (r = 0.4374), left eye (r = 0.3580).Conclusion: The area of superficial FAZ of the right and left eyes was significantly higher in the hypertensive patients. The deep FAZ area of both eyes, however showed similar mean areas between the study and control groups.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131204404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intranasal Neurostimulation for Dry Eye: First Impressions","authors":"W. Faulkner, S. Granat","doi":"10.18314/CTOY.V2I1.1638","DOIUrl":"https://doi.org/10.18314/CTOY.V2I1.1638","url":null,"abstract":"Although many new and helpful treatments for dry eye disease have been developed, there remains a subset of patients who continue to look for easier or more effective treatments. A consecutive group of 28 moderate to severe dissatisfied dry eye patients in one practice were surveyed after initial exposure to and trial with a novel intranasal neurostimulation technique. Results were overall positive. Seventy-one percent had a favorable impression. Average rating on 1-10 scale was 6.92. Twenty-five percent purchased the device immediately despite no insurance coverage. Of those who did not buy, 100% said they would consider purchase later. Time and experience will show how valuable this new technology is and how it fits in the dry eye armamentarium.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125439600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ophthalmic Compounding and Implications of Revised United States Pharmacopeia Chapter 797 Standards","authors":"J. Jorgenson, M. K. Jensen, F. Massoomi","doi":"10.18314/ctoy.v2i1.1508","DOIUrl":"https://doi.org/10.18314/ctoy.v2i1.1508","url":null,"abstract":"Following the devastating results of the New England Compounding Center debacle resulting from contaminated compounded steroid injections, which occurred in 2012, state and national attention focusing on the safety of compounded sterile products has continued to escalate. The Drug Quality and Security Act (DQSA) was passed, which created voluntary outsourcing facilities under section 503B as a new class of compounders regulated by the FDA. Section 503B compounding follows Current Good Manufacturing Process (cGMP) standards. FDA guidance documents addressing sterile compounding are also continuing to increase in volume and specificity. Traditional compounding efforts under DQSA section 503A remain the purview of state oversight but FDA does reserve the right to intervene at any time for quality concerns. The primary standards for 503A compounding are found in the United States Pharmacopeia (USP) Chapter <797>. These standards are currently under revision and the enhanced standards are scheduled for implementation December 2019. Typically, State Boards of Pharmacy have provided oversight and inspections on compounding but these efforts have been focused mainly on pharmacy operations. Ophthalmic compounding outside of hospital or retail pharmacy settings has gone largely unregulated. However, the revised USP <797> is intended to address all sites providing sterile compounding and eye centers performing these functions will be expected to be in full compliance with the new standards by the implementation date.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123442864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Ophthalmic Changes in Patients with Chronic Obstructive Pulmonary Disease: Case-Control Study","authors":"C. Brandt, Milena Amorim De Souza, D. Gadelha, Maria Cecília Santos Cavalcanti Melo, R. D. C. S. Cruz","doi":"10.18314/ctoy.v2i1.1452","DOIUrl":"https://doi.org/10.18314/ctoy.v2i1.1452","url":null,"abstract":"Purpose: To evaluate the prevalence of ophthalmological changes in patients with Chronic Obstructive Pulmonary Disease (COPD) cared for at the Pneumology and Ophthalmology Departments at Medical School Unifacisa-Campina Grande-Paraiba-Brazil.Materials and Methods: Twenty-two smoker patients with COPD (study group) and 22 healthy controls that underwent routine ophthalmological examination (control group) were enrolled in the investigation. They were homogeneous regarding age, gender, presence of Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM). They were examined for the presence of cataract and Age Related Macular Disease (AMD).Results: The prevalence of ophthalmologic changes was significantly different in the two groups. Eight (36.4%)patients presented with cataract requiring surgical intervention, while one (4.5%) person in the control group had cataract (p = 0.0212). Regarding AMD, 10 (45.5%) smoker COPD patients had this disease, whereas in the control group, one (4.5%) person had this disease (p = 0.0039).Conclusion: From the results one can conclude that there is strong association between smokers diagnosed with COPD with cataract and AMD patients, reinforcing the need for a protocol for referral of these patients to the ophthalmologist.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122530760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Glaucoma beyond Intraocular Pressure","authors":"J. Fischer, M. Mozaffarieh","doi":"10.18314/CTOY.V1I1.1550","DOIUrl":"https://doi.org/10.18314/CTOY.V1I1.1550","url":null,"abstract":"Glaucoma is a major cause of vision loss worldwide with nearly 8 million people bilaterally blind from the disease. This number is estimated to increase over the next years. The key to preventing blindness from glaucoma is effective diagnosis and treatment. The classical glaucoma treatment focuses on IOP reduction. Increased IOP is indeed an undisputable risk factor for the development and progression of Glaucomatous Optic Neuropathy (GON). But there is mounting evidence in literature that other risk factors are involved as well. These additional factors may by themselves lead to GON or they may render the eye more sensitive to IOP. Among the most often described factors are: Flammer-syndrome, low blood pressure, increased retinal venous pressure, oxidative stress. Better knowledge of the pathogenesis has opened up additional therapeutical approaches often called non-IOP lowering treatment. Whilst most of these new avenues of treatment are still in the experimental phase, others are already used by some physicians. Non-IOP lowering treatment includes improvements of ocular blood flow, particularly blood flow regulation. This can be achieved by improving the regulation of ocular blood flow (improving auto regulation) by drugs such as carbonic anhydrase inhibitors, magnesium or calcium channel blockers. These drugs also in part decrease increased retinal venous pressure in the eyes of patients. Increased retinal venous pressure decreases perfusion pressure in the patients’ eyes and thus increases the risk of glaucomatous progression. The patients’ blood pressure also needs to be monitored carefully as low blood pressure, particularly nocturnal over dips or blood pressure fluctuations, increase the risk of further damage. Blood pressure can be increased by an increase in salt intake or in rare cases by treatment with fludrocortisone. Reduction of oxidative stress, especially at the level of mitochondria, also seems to be protective. This can be achieved by gingko or foods rich in polyphenolic flavonoids.This review describes the individual mechanisms which may be targeted by non-IOP lowering treatment.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122064648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Angiography for the Anterior Segment and Posterior Fundus of Eyes with Anterior Segment Neovascularization using Heidelberg Retina Angiograph 2","authors":"Yuji Sakino, Y. Noda, Maho Itotani, Takako Nakamuro, K. Kiyosaki, Katsuhiko Yokoyama, T. Kubota","doi":"10.18314/ctoy.v2i1.1450","DOIUrl":"https://doi.org/10.18314/ctoy.v2i1.1450","url":null,"abstract":"Objective: To present a method of indocyanine green angiography (IA) and fluorescein sodium angiography (FA) for simultaneously evaluating anterior segment neovascularization and fundus abnormality.Participants: We examined 19 eyes of 19 patients suspected of having neovascularization in the anterior segment of the eye. Seventeen eyes of 17 patients suffered from proliferative diabetic retinopathy, and two eyes of 2 patients had central retinal vein occlusion.Methods: Using Heidelberg Retina Angiograph 2 (HRA2), we performed angiography of the anterior and posterior segment of the eye.Results: Of the 19 cases, anterior segment neovascularization was clearly observed with slit-lamp examination and gonioscopy in 12 eyes (63.1%). However, anterior segment neovascularization was detected by HRA2 angiography in 18 eyes (94.7%). Posterior segment angiography revealed non-perfusion area in 16 eyes (84.2%) and retinal neovascularization in 10 eyes (52.6%). In one case, the posterior segment findings were not obtained due to vitreous hemorrhaging.Conclusion: Simultaneous anterior and posterior segment HRA2 angiography using indocyanine green andfluorescein sodium is a useful technique for detecting neovascularization in the anterior segment of the eye as well as non-perfusion areas and neovascularization of the retina.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115592392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Annexin A1 Protein in an Infectious Keratitis Model: Therapeutic Perspectives","authors":"Rafael Fernández Da Silva, A. Hamade, G. Silva, Gabriel Pereira, F. Oliveira, H. R. Souza, L. Possebon, A. P. Girol","doi":"10.18314/ctoy.v2i1.1478","DOIUrl":"https://doi.org/10.18314/ctoy.v2i1.1478","url":null,"abstract":"Introduction: bacterial keratitis caused by Pseudomonas aeruginosa is one of the causes of blindness in the world, due to pathogenicity of the bacteria that can lead to corneal perforation. Studies on the protein annexin A1 (AnxA1) point it as one of the essential mediators in homeostasis of inflammation and ocular infections. However, there are no known reports of AnxA1 in keratitis. Objetive: to investigate the expression profile of AnxA1 in the P. aeruginosainduced keratitis model in two strains of mice (susceptible and pathogen resistant).Method: for the development of experimetal keratitis, the mice had their right eyes ulcerated and immediately inoculated with 5 μl of P. aeruginosa in PBS. The animals were euthanized after 24 hours of the bacteria inoculation. The eyes were clinically evaluated and histopathologically processed for quantitative analyses of the inflammatory infiltrate and immunohistochemical studies of the expressions of the AnxA1 and the receptor for formylated peptides (fpr2).Results: our results demonstrated a higher influx of inflammatory cells, mainly neutrophils in the susceptible animals (C57BL / 6) compared to those considered resistant (BALB / c) and controls. Immunohistochemical studies indicated weak expression of AnxA1 and fpr2 in the anterior epithelium and stroma of the cornea. However, after keratitis induction, overexpression of AnxA1 and fpr2 occurred in the corneas of both mice strains. Furthermore, greater expression of AnxA1 in the anterior corneal epithelium was observed in the C57BL / 6 animals.Conclusions: AnxA1 and fpr2 may be related to infectious keratitis induced by P.aeruginosa, which stimulates further investigations on the use of AnxA1 as a possible coadjuvant therapeutic strategy in bacterial keratitis.","PeriodicalId":110594,"journal":{"name":"Current Trends in Ophthalmology","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116060802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}