European Journal of Ophthalmology最新文献_第7页

Real-world experience with fluocinolone acetonide intravitreal implant in patients with diabetic macular edema. 糖尿病黄斑水肿患者使用氟西诺龙醋酸苷玻璃体内植入剂的真实体验。

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-02-23 DOI: 10.1177/11206721241235266

Luigi Capone, Pietro Airaghi, Pasquale Aragona, Nicolò Castellino, Maria Vittoria Cicinelli, Francesco Ciucci, Michele Coppola, Cristiano De Gaetano, Rosangela Lattanzio, Massimo Lorusso, Martina Maceroni, Maria Elena Malvasi, Luisa Marco, Michele Marraffa, Gaia Martini, Rodolfo Mastropasqua, Angelo Maria Minnella, Eleni Nikolopulou, Elina Ortisi, Elena Pacella, Vincenzo Papa, Claudio Pennesi, Michele Reibaldi, Stanislao Rizzo, Lisa Toto, Luigi Trombetta, Francesco Bandello

{"title":"Real-world experience with fluocinolone acetonide intravitreal implant in patients with diabetic macular edema.","authors":"Luigi Capone, Pietro Airaghi, Pasquale Aragona, Nicolò Castellino, Maria Vittoria Cicinelli, Francesco Ciucci, Michele Coppola, Cristiano De Gaetano, Rosangela Lattanzio, Massimo Lorusso, Martina Maceroni, Maria Elena Malvasi, Luisa Marco, Michele Marraffa, Gaia Martini, Rodolfo Mastropasqua, Angelo Maria Minnella, Eleni Nikolopulou, Elina Ortisi, Elena Pacella, Vincenzo Papa, Claudio Pennesi, Michele Reibaldi, Stanislao Rizzo, Lisa Toto, Luigi Trombetta, Francesco Bandello","doi":"10.1177/11206721241235266","DOIUrl":"10.1177/11206721241235266","url":null,"abstract":"Objectives: to evaluate long-term effectiveness and safety of fluocinolone acetonide (FAc) implant used as second-line treatment in patients with persistent diabetic macular edema (DME).Methods: retrospective data chart review of 241 pseudophakic eyes of 178 patients treated with FAc from July 2017 to December 2021 in 10 medical retinal units in Italy. The primary endpoint was the change of best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 2 years. A Student's paired t-test was used. Additional therapies for DME and intraocular pressure (IOP)-related events were also evaluated.Results: efficacy of FAc was assessed in a subset of 111 eyes with at least 24 months of follow-up. Mean BCVA increased at 2 years by 5.1 ETDRS letters (95%CI = 2.6-7.5; p < 0.001) while mean CMT decreased by 189 µm (95% CI 151-227; p < 0.001). Thirty-eight of these eyes (34.2%) needed additional intravitreal treatments, mainly anti-VEGF. Safety was evaluated on the entire cohort of 241 eyes treated with FAc. Overall, 66 eyes (27.4%) required emergent IOP-lowering medications (typically within the first-year post FAc) while 14 eyes (5.8%) underwent trabeculectomy, mostly during the second year of follow-up.Conclusion: FAc implant provides a substantial long-term functional and anatomical benefit when used as second-line treatment in eyes with DME. IOP rise can be adequately managed with topical agents although some eyes may require IOP-lowering surgery.","PeriodicalId":12000,"journal":{"name":"European Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139939851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Laser flare photometry in eyes receiving brolucizumab intravitreal injections for age related macular degeneration. 接受布鲁珠单抗玻璃体内注射治疗老年性黄斑变性的眼睛的激光耀斑光度测量。

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-03-06 DOI: 10.1177/11206721241236917

Nikolaos Chadoulos, Anna Dastiridou, Andreas Mitsios, Ioannis Tsinopoulos, Christos Kalogeropoulos, Sofia Androudi

{"title":"Laser flare photometry in eyes receiving brolucizumab intravitreal injections for age related macular degeneration.","authors":"Nikolaos Chadoulos, Anna Dastiridou, Andreas Mitsios, Ioannis Tsinopoulos, Christos Kalogeropoulos, Sofia Androudi","doi":"10.1177/11206721241236917","DOIUrl":"10.1177/11206721241236917","url":null,"abstract":"Purpose: To measure aqueous flare levels in treatment naïve eyes suffering from wet age- related macular degeneration (wAMD) treated with intravitreal brolucizumab.Methods: Patients with treatment naïve wAMD in one eye were prospectively enrolled. Flare levels were measured with laser flare photometry at baseline, 1 day and 1 month after each of the 3 monthly injections during the loading phase.Results: Twenty-two eyes from 22 patients aged 76.7 ± 6.0 years were enrolled. Flare values were 10.6 ± 3.7 photons/msec at baseline and 12.6 ± 5.8 photons/msec at the last follow up visit, 1 month after the third injection (p = 0.289, repeated measures ANOVA). The mean change in flare after the first injection was 4.2 ± 3.6. photons/msec, 6.6 ± 8.9 photons/msec after the 2nd and 8.6 ± 20.8 photons/msec after the 3rd injection (p = 0.640, repeated measures ANOVA). No patient had clinical signs of intraocular inflammation.Conclusions: Eyes receiving brolucizumab injections for wAMD showed similar flare at baseline, during and 1 month after completion of three-monthly intravitreal injections. There was no evidence of subclinical inflammation during the loading phase of brolucizumab based on laser flare photometry measurements.","PeriodicalId":12000,"journal":{"name":"European Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A novel approach to remove retained lens material: Suction-assisted elevation and anterior chamber phacoemulsification. 清除滞留晶状体材料的新方法：抽吸辅助提升和前房超声乳化术。

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-08-05 DOI: 10.1177/11206721241269328

Antonia Maria Luce De Vitto, Paolo Santorum, Enrico Bertelli

{"title":"A novel approach to remove retained lens material: Suction-assisted elevation and anterior chamber phacoemulsification.","authors":"Antonia Maria Luce De Vitto, Paolo Santorum, Enrico Bertelli","doi":"10.1177/11206721241269328","DOIUrl":"10.1177/11206721241269328","url":null,"abstract":"Purpose: To describe and evaluate the feasibility of a novel pars plana vitrectomy (PPV) technique for the removal of retained lens material (RLM), which obviates the need for either 20-gauge intravitreal fragmentation or perfluorocarbon-assisted elevation.Methods: Interventional case series. After thorough 23-gauge PPV, the hard lens material is engaged and held adherent to the vitreous cutter using aspiration, then raised into the anterior chamber. There, a standard phacoemulsification probe, inserted through a corneal incision, is used to fragment and remove the material.Results: Three eyes of 3 patients were operated on. In all eyes, RLM could be removed completely. Postoperatively, 2 of 3 eyes (67%) achieved 20/20 best-corrected visual acuity. No complications such as glaucoma, cystoid macular edema, corneal edema, or retinal detachments were recorded. Intraoperatively, retinal tears were detected in 2 of 3 (67%) eyes and treated with endolaser retinopexy and fluid-air exchange. One eye subsequently developed macular hole requiring further surgery.Conclusion: Suction-assisted lens elevation may be a viable and convenient technique to remove RLM during PPV. Although the comparison with other methods is beyond the scope of this preliminary study, visual outcomes and complication rates were encouraging and should be validated in a larger group of patients.","PeriodicalId":12000,"journal":{"name":"European Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pigment epithelial detachment composition indices in central serous chorioretinopathy as a biomarker for disease activity: A computational methodology and 1 year outcomes. 中心性浆液性脉络膜视网膜病变中的色素上皮脱落组成指数作为疾病活动的生物标志物：计算方法和 1 年结果。

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-02-26 DOI: 10.1177/11206721241235052

Sanya Yadav, Joshua Ong, Arman Zarnegar, Matthew Driban, Amrish Selvam, Supriya Arora, Sumit Randhir Singh, Jay Chhablani

{"title":"Pigment epithelial detachment composition indices in central serous chorioretinopathy as a biomarker for disease activity: A computational methodology and 1 year outcomes.","authors":"Sanya Yadav, Joshua Ong, Arman Zarnegar, Matthew Driban, Amrish Selvam, Supriya Arora, Sumit Randhir Singh, Jay Chhablani","doi":"10.1177/11206721241235052","DOIUrl":"10.1177/11206721241235052","url":null,"abstract":"Purpose: Investigation of pigment epithelial detachment (PED) characteristics in central serous chorioretinopathy (CSCR) is underrepresented in the literature. We present a novel computational approach to quantify PED composition indices (PEDCI) in CSCR and track changes over time.Methods: 34 eyes with active CSCR were analyzed quarterly over a 1-year period. Cases were categorized into acute and chronic CSCR depending on a symptom duration of less than 3 months or more than 3 months respectively. PED, retinal and choroidal dimensions were manually measured, and interval changes were compared using repeated measures of variance ANOVA. PED composition analysis involved manual segmentation followed by automated sub segmentation of PED areas to identify serous, neovascular and fibrous tissues. PEDCI for each component was compared among cases of acute and chronic CSCR.Results: CMT and NSD-h decreased by 65.2 µm (p = 0.01), and 86.5 µm (p < 0.01) respectively at 12 months. At baseline, 7/17 acute CSCR eyes and 8/15 chronic CSCR eyes had a concomitant PED; acute cases had both serous and neovascular components (PEDCI-S: 16.95%, PEDCI-N: 40.3%), whereas chronic cases only had a neovascular component (PEDCI-S: 0%, PEDCI-N: 30.5%). At 12-month follow-up, 6/7 of acute CSCR group and 6/8 chronic CSCR group had a concomitant PED; PEDCI-S was largest for acute CSCR (53.4%) and PEDCI-N was largest for chronic CSCR (46.7%).Conclusion: We identify a novel biomarker PEDCI to differentiate acute and chronic CSCR with higher PEDCI-S in acute CSCR, and higher PEDCI-N in chronic CSCR.","PeriodicalId":12000,"journal":{"name":"European Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Uveal metastasis arising from thyroid neoplasms: A case study synthesis. 甲状腺肿瘤引发的葡萄膜转移：病例研究综述。

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-03-05 DOI: 10.1177/11206721241236528

Mirsaeed Abdollahi, Hooman Nateghian, Navid Sobhi, Alireza Abdshah, Ali Jafarizadeh

{"title":"Uveal metastasis arising from thyroid neoplasms: A case study synthesis.","authors":"Mirsaeed Abdollahi, Hooman Nateghian, Navid Sobhi, Alireza Abdshah, Ali Jafarizadeh","doi":"10.1177/11206721241236528","DOIUrl":"10.1177/11206721241236528","url":null,"abstract":"Purpose: We systematically reviewed the case report literature to identify cases of uveal metastases originating from thyroid cancer (TC), evaluate factors and indications in uveal metastases from TC, and provide clinical insights through recent case studies.Methods: Web of Science, Medline, and Scopus databases were searched for case reports or series reporting uveal metastasis from a thyroid neoplasm. Articles published in any language from inception through November 2022 were searched and screened independently by two reviewers. The quality of the included studies was assessed using the JBI Critical Appraisal Checklist for Case Reports.Results: A total of 1049 records were screened, resulting in the identification of 46 cases from 43 studies. The mean (SD) age at uveal metastases diagnosis was 58.44 (±17.99) years with the median (interquartile range) of 56.5 (29.75) (range, 20-83 years), with 34.8% of cases (16/46) cases reported in elderly patients (>64 years). The sample consisted of 56.5% (26/46) male patients. Uveal metastases were observed in the right eye in 16 cases, the left eye in 19 cases, and both eyes in 11 cases. Choroidal involvement was present in 84.8% of cases (39/46) cases. Papillary carcinoma was the most common thyroid cancer type (34.8%, 16/46), followed by follicular carcinoma (32.6%, 15/46), and medullary carcinoma (21.7%, 10/46).Conclusion: Uveal metastases have been observed to appear in metastatic TC, and physicians should approach ocular symptoms cautiously in cases that accompany a neck mass or a history of previous TC.","PeriodicalId":12000,"journal":{"name":"European Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140039002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical management of oculomotor nerve palsy - a review of the literature. 眼球运动神经麻痹的手术治疗--文献综述。

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-02-01 DOI: 10.1177/11206721241229758

Jake Hankinson, Asmaa Shuaib

引用次数: 0

Conditions for modifying intraocular lenses as drug carriers for methotrexate using poly (lactic-co-glycolic acid). 使用聚（乳酸-共聚-乙醇酸）对作为甲氨蝶呤药物载体的眼内透镜进行改性的条件。

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-03-18 DOI: 10.1177/11206721241239717

Clarissa Bill, Stefan Kassumeh, Christina Hilterhaus, Natalie Tersi, Arne J Speidel, Andreas Ohlmann, Siegfried Priglinger, Claudia Priglinger, Armin Wolf, Christian M Wertheimer

{"title":"Conditions for modifying intraocular lenses as drug carriers for methotrexate using poly (lactic-co-glycolic acid).","authors":"Clarissa Bill, Stefan Kassumeh, Christina Hilterhaus, Natalie Tersi, Arne J Speidel, Andreas Ohlmann, Siegfried Priglinger, Claudia Priglinger, Armin Wolf, Christian M Wertheimer","doi":"10.1177/11206721241239717","DOIUrl":"10.1177/11206721241239717","url":null,"abstract":"Introduction: The intraocular lens (IOL) can be used as a slow-release drug carrier in cataract surgery to alleviate posterior capsular opacification (PCO). The following is a systematic development of an IOL using methotrexate and the solvent casting process with poly (lactic-co-glycolic acid) (PLGA) as a carrier polymer.Methods: Different solvents for PLGA and methotrexate were tested for dissolution properties and possible damage to the IOL. The required biological concentration of methotrexate was determined in human capsular bags implanted with an IOL. To detect fibrosis, α-SMA, f-actin, and fibronectin were labelled by immunofluorescence staining. Cell proliferation and extracellular matrix contraction were observed in a lens epithelial cell line (FHL-124). Finally, the IOL was designed, and an ocular pharmacokinetic model was used to measure drug release.Results: Solvent mixtures were found to allow coating of the IOL with drug and PLGA without damaging it. PCO in the capsular bag model was inhibited above 1 μM methotrexate (p = 0.02). Proliferation in FHL-124 was significantly reduced above a concentration of 10 nM (p = 0.04) and matrix contraction at 100 nM (p = 0.02). The release profile showed a steady state within therapeutic range.Conclusion: After determination of the required physicochemical manufacturing conditions, a drug releasing IOL was designed. A favourable release profile in an ocular pharmacokinetics model could be shown.","PeriodicalId":12000,"journal":{"name":"European Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A bibliometric and citation network analysis of crosslinking. 交叉链接的文献计量学和引文网络分析。

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-08-14 DOI: 10.1177/11206721241272177

Miguel Ángel Sánchez-Tena, Clara Martínez Pérez, Cesar Villa-Collar, Cristina Alvarez-Peregrina

{"title":"A bibliometric and citation network analysis of crosslinking.","authors":"Miguel Ángel Sánchez-Tena, Clara Martínez Pérez, Cesar Villa-Collar, Cristina Alvarez-Peregrina","doi":"10.1177/11206721241272177","DOIUrl":"10.1177/11206721241272177","url":null,"abstract":"Purpose: Research on crosslinking has focused mainly on trying to slow the progression of keratoconus. The objective of this bibliometric analysis is to determine the relationships between the different publications and authors. As well as to identify the different areas of research on crosslinking. Methods: Web of Science (WOS) was the database for the search of publications for the period 1972 to December 2023, using the terms: crosslinking, cross-linking, ocular, vision, visual, cornea, ectasia AND Keratoconus. The analysis of the publication was performed using the CitNetExplorer, VOSviewer and CiteSpace software. Results: 7161 publications and 59415 citation networks were found. The year with the most publications is 2021, a total of 571 (7.97%) publications and 135 citation networks. The most cited publication was \"Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus\" published by Wollensak et al. in 2003, with a citation index of 1780. Using the Clustering function, five groups were found that cover the main research areas in this field: keratoconus, corneal transplantation, cataracts, corneal inflammation and axial growth. Conclusion: The treatment of keratoconus continues to be the topic of interest in this area of research. However, in recent years there has been an increase in research on how crosslinking helps to slow down axial growth.","PeriodicalId":12000,"journal":{"name":"European Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric limbal stem cell deficiency: An overview of a rarely studied pathology. 小儿角膜缘干细胞缺乏症：罕见病理概述

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-10-30 DOI: 10.1177/11206721241291995

Nesrin Tutas Günaydın, Ozlem Barut Selver

{"title":"Pediatric limbal stem cell deficiency: An overview of a rarely studied pathology.","authors":"Nesrin Tutas Günaydın, Ozlem Barut Selver","doi":"10.1177/11206721241291995","DOIUrl":"https://doi.org/10.1177/11206721241291995","url":null,"abstract":"The cornea is the outermost transparent layer of the eye, and the continuous renewal of the corneal epithelium is important for its transparency. This process is primarily facilitated by corneal stem cells, most of which are found at the limbus. However, any deterioration or damage in this region leads to corneal conjunctivalization and consequent limbal stem cell deficiency (LSCD), which compromises corneal transparency. LSCD is an important condition, especially in the pediatric population, as it can lead to corneal vascularization, opacity and ultimately loss of vision and subsequent amblyopia, unlike adults. Although pediatric LSCD is often due to chemical injuries, as in adults, it is also caused by conditions such as congenital aniridia, Steven Johnson Syndrome and various other immunological disorders. Appropriate and timely treatment in pediatric LSCD is of particular importance in preventing progression to amblyopia, unlike adults. Accurate staging of the disease is essential for the necessary medical and surgical treatment decision. While medical approaches are at the forefront to eliminate the causative agent and improve the ocular surface in reversible cases, it is essential to replace the limbal stem cells lost in advanced disease. For these replacement procedures, it is noteworthy that there is a tendency for minimally invasive methods compared to adults to avoid possible complications due to long life expectancy in children. In conclusion, although there are various reviews on limbal stem cell deficiency (LSCD) in adults, we believe that this review for childhood LSCD will make an important contribution to the literature, since the relevant literature currently reported for the pediatric population is limited.","PeriodicalId":12000,"journal":{"name":"European Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Avacopan in the treatment of refractory scleritis secondary to granulomatosis with polyangiitis: A case report. 阿伐潘治疗继发于肉芽肿伴多血管炎的难治性巩膜炎：病例报告。

IF 1.4 4区医学

European Journal of Ophthalmology Pub Date : 2024-10-30 DOI: 10.1177/11206721241295298

Emilia Bober, Bhavana Sharma, Ioannis Papasavvas, Stephen McAdoo, Harry Petrushkin

{"title":"Avacopan in the treatment of refractory scleritis secondary to granulomatosis with polyangiitis: A case report.","authors":"Emilia Bober, Bhavana Sharma, Ioannis Papasavvas, Stephen McAdoo, Harry Petrushkin","doi":"10.1177/11206721241295298","DOIUrl":"https://doi.org/10.1177/11206721241295298","url":null,"abstract":"Purpose: Avacopan is a novel C5a receptor inhibitor which was recently licensed for treatment of severe granulomatosis with polyangiitis (GPA) in the European Union and the United Kingdom. To the best of our knowledge, this is the first described case on initial ophthalmic outcomes in a patient with severe GPA and concurrent refractory scleritis treated with avacopan.Case description: We present a case of de novo scleritis in a 77-year-old male with a background of retinitis pigmentosa with Argus II implant in situ. Severe scleral inflammation occurred following a suture removal from the implant site. Remission was not maintained despite orbital floor injections and high dose oral prednisolone. The diagnostic work-up revealed GPA which quickly progressed to involve vital organs. In view of his systemic deterioration, he was started on avacopan alongside rituximab, cyclophosphamide and high dose oral prednisolone. Sustained remission of scleritis was noted after 7 months of treatment with avacopan and low dose oral prednisolone with no other maintenance immunosuppression.Conclusion: We observed a sustained benefit of avacopan in allowing for successful taper of systemic steroids. We report that avacopan used alongside other immunosuppressants may be a viable option in patients with GPA and concurrent refractory scleritis. Further studies are needed to establish the longer term impact of this agent on the control of scleral inflammation.","PeriodicalId":12000,"journal":{"name":"European Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0