International Ophthalmology Clinics最新文献

{"title":"Comparing Teleretinal Screening-Identified Diabetic Retinopathy With Diabetic Nephropathy and Other Markers of Systemic Disease.","authors":"Sean M Rodriguez, Eric B Hamill, Amritha Sundaresan, Danielle Guffey, Christina Y Weng","doi":"10.1097/IIO.0000000000000544","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000544","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic retinopathy and diabetic nephropathy are two major life-altering complications of diabetes mellitus. Identifying permissive and protective factors for diabetic retinopathy and nephropathy is imperative so that diabetic quality of life can be optimized and downstream complications can be minimized.</p><p><strong>Methods: </strong>We performed a large retrospective chart review of 997 patients at a county medical center with a majority Hispanic population. Through multivariable regression analysis, we identified significant factors associated with the presence of diabetic retinopathy or diabetic nephropathy. We also identified patients with a discordance between diabetic control and the severity of diabetic retinopathy and nephropathy.</p><p><strong>Results: </strong>Chronic kidney disease, baseline HbA1c, and systolic blood pressure were found to be positive risk factors for both diabetic retinopathy and diabetic nephropathy. Beta-blocker use and insulin use were identified as positive risk factors for diabetic retinopathy but not diabetic nephropathy. A higher body metabolic index (BMI) was found to be protective for diabetic retinopathy. We identified 7 patients with poor diabetic control (HbA1c >10%) but no diabetic retinopathy. There were no outlier patients found in the low glycemic exposure group.</p><p><strong>Conclusions and importance: </strong>Our results are similar to other large-cohort reviews identifying factors associated with diabetic retinopathy and nephropathy. We identified a small cohort with discordance between diabetic control and the development of diabetic retinopathy or nephropathy. Future studies should be conducted looking into reasons for the anomalous progression of disease in certain patients.</p>","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"27-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877136","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":"Follow-up Adherence After Teleretinal Screening for Diabetic Retinopathy.","authors":"Paul D Chamberlain, Rishabh C Date, Kevin L Shen, Giovanni A Campagna, Linda B Piller, Yvonne I Chu, Christina Y Weng","doi":"10.1097/IIO.0000000000000540","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000540","url":null,"abstract":"<p><strong>Aim: </strong>Determine the follow-up rate for patients referred following an abnormal teleretinal imaging (TRI) screening and examine patient characteristics predictive of follow-up nonadherence.</p><p><strong>Materials and methods: </strong>A cross-sectional study of patients screened between August 2014 and July 2016 in the Harris Health System (HHS) in Houston, TX. All diabetic patients referred for in-person examination, who had data for all study variables, and who did not have established ophthalmic care in the HHS within the previous 2 years were included. Data collected included TRI findings, clinic location, age, race, gender, hemoglobin A1C (HbA1c), and insulin use. The primary outcome was whether or not a patient attended an in-person follow-up visit. Attendance was the dependent variable in a multivariable logistic regression with the aforementioned exposures used as independent variables.</p><p><strong>Results: </strong>There were 1695 patients included in the study. The follow-up rate (ie, the percentage of patients who went for an in-person examination with an ophthalmologist following a positive screening test and referral) was 54.9%. TRI findings of proliferative diabetic retinopathy (PDR) + referable diabetic macular edema (DME) predicted poorer compliance with follow-up recommendations compared to patients with PDR alone (OR 0.64, 95% CI 0.42-0.99; P=0.046). Age, race, gender, glycemic control, and insulin use did not predict compliance.</p><p><strong>Conclusion: </strong>Age, race, gender, glycemic control, and insulin use were not found to be predictive of follow-up compliance rates; the most severe disease (PDR + DME) predicted noncompliance. Diabetic retinopathy screening programs may consider more aggressive measures in emphasizing compliance in patients with the worst disease as these patients are more likely to miss follow-up appointments. More studies are needed to characterize risk factors for noncompliance.</p>","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877141","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":"Head-mounted Devices for Low Vision: A Review.","authors":"Sean M Yuan, Michael Rafaelof, Jennifer D Huang, Mitul C Mehta","doi":"10.1097/IIO.0000000000000550","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000550","url":null,"abstract":"<p><p>Head-mounted devices (HMDs) are wearable electronic tools designed to augment the visual experience of low-vision patients who have a decrease in vision not improved by refractive correction. They do so by addressing various principles of visual enhancement, including magnification, illumination, increased field of view, and contrast sensitivity enhancement, among others. Since the introduction of the first HMD 3 decades ago, advancements in technology have made these devices more lightweight and practical for everyday use. More sophisticated features have been developed, including augmented reality, virtual reality, text-to-speech, and blind spot remapping. However, despite these advancements, HMDs still face a host of challenges, including cost, customizability to specific patient factors, and social stigma. In this paper, we present a broad overview of HMDs, review major products available commercially, and discuss the challenges and future directions for this rapidly growing field.</p>","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877150","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":"Preface: Advances in Technology for Retinal Diseases.","authors":"Christina Y Weng","doi":"10.1097/IIO.0000000000000553","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000553","url":null,"abstract":"","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877162","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":"Tyrosine Kinase Inhibitors: The Next Chapter in Reducing Treatment Burden for Exudative Retinal Diseases?","authors":"Pranesh Ravichandran, Cecilia Canizela, Abrahem Sayed, Rehan M Hussain","doi":"10.1097/IIO.0000000000000551","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000551","url":null,"abstract":"<p><p>Tyrosine kinase inhibitors (TKIs) serve to inhibit the phosphorylation cascade that usually leads to abnormal processes such as vascular leakage and tumorigenesis. Within retinal diseases specifically, dysregulation of the vascular endothelial growth factor receptor tyrosine kinases can lead to age-related macular degeneration and diabetic macular edema. These diseases have a growing prevalence and are leading causes of vision loss. The current standard of care requires repeated administration of anti-vascular endothelial growth factor injections, which poses a significant burden on patients. Novel TKIs provide an opportunity to reduce injection frequency by targeting a broader range of molecules involved in angiogenesis and exudation. This review will cover TKIs in development and how their use of different technologies and targets may enhance visual and anatomic outcomes for patients with exudative retinal disease.</p>","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"9-15"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877244","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":"Retinitis Pigmentosa and Therapeutic Candidates.","authors":"Chelsea A Livingston, Christina Y Weng, John R Chancellor","doi":"10.1097/IIO.0000000000000542","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000542","url":null,"abstract":"<p><p>Retinitis pigmentosa (RP) is a class of inherited retinal dystrophies (IRDs) that involves the degeneration of retinal photoreceptor cells and results in progressive vision loss. It was identified and named in 1857. For over 100 years, treatment of RP was generally limited to modifications in diet, management of cystoid macular edema, and supportive care for low vision. Over the last several decades, advances in technology and our understanding of the human genome have led to a host of new therapeutic candidates for the treatment of RP. This includes gene and cell therapy, optogenetics, neuroprotective agents, and electronic retinal implants. In this article, we summarize both the traditional and novel therapeutic modalities for the treatment of retinitis pigmentosa.</p>","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877192","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":"Update on Management of Retinopathy of Prematurity: A Review.","authors":"Celine Chaaya, Sandra Hoyek, Nimesh A Patel","doi":"10.1097/IIO.0000000000000552","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000552","url":null,"abstract":"<p><p>Retinopathy of prematurity (ROP) remains a significant health care concern in neonatal care as advances in neonatal intensive practices have improved the survival rates of premature infants. The management and screening of ROP have evolved significantly, with notable trends and advancements aimed at improving outcomes. The use of intravitreal antivascular endothelial growth factor injections has emerged as a prominent initial treatment for ROP in addition to laser photocoagulation. Screening practices have also seen enhancements, with a shift toward efficiency and tele-screening to optimize ROP management. This review aims to discuss available treatment and screening methods and explore new potential therapeutic tools for ROP.</p>","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"81-90"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877254","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":"Retropupillary Iris Clip Intraocular Lenses: A Case Series of 57 Eyes.","authors":"Pauline Mallick, Adrian T Fung","doi":"10.1097/IIO.0000000000000548","DOIUrl":"10.1097/IIO.0000000000000548","url":null,"abstract":"<p><strong>Purpose: </strong>To report visual and refractive outcomes and intraoperative and postoperative complications after pars plana vitrectomy (PPV) with retropupillary implantation of an iris clip intraocular lens (IOL).</p><p><strong>Methods: </strong>This is a retrospective case series of patients who underwent secondary retropupillary intraocular lens insertion combined with pars plana vitrectomy to treat aphakia secondary to a dislocated nucleus lens (group A); or IOL dislocation (group B). Patient demographics, preoperative visual and refractive outcomes, intraoperative factors, postoperative visual and refractive outcomes, and complications within the follow-up period ranging from 6 months up to 3 years postoperative, were recorded.</p><p><strong>Results: </strong>In total, 57 eyes of 50 patients were included with a follow-up range of 6 months to 3 years. The overall mean age was 77.0 years (range 28 to 99 years), with 26/50 (52%) of patients being male. There were 13/57 (22.8%) patients in group A and 44/57 (77.2%) patients in group B. The single most common identifiable cause for lens dislocation was pseudoexfoliation, which was seen in 13/57 (22.8%) of eyes. The mean improvement in visual acuity (baseline and final follow) was 0.72 logMAR (1.09 logMAR to 0.37 logMAR) in all patients, 1.12 logMAR (1.64 logMAR to 0.52 logMAR) in group A, and 0.60 logMAR (0.91 logMAR to 0.31 logMAR) in group B. In 46 eyes (80.7%), postoperative refractive errors were within ±1.00 dioptres (D) of the target refraction, with a mean difference of 0.36D from target refraction. Complications included corneal edema (35.1%), hyphema (26.3%), anterior chamber inflammation (26.3%), vitreous hemorrhage (14%), elevated intraocular pressure (IOP, 12.3%) and cystoid macular edema (CME, 5.3%). All these complications were managed with topical medical therapy and did not require further surgical intervention. One eye from group A was the only eye that developed retinal detachment (RD) or endophthalmitis. No patients had IOL dislocation in the postoperative follow-up period, which ranged from 6 months to 3 years.</p><p><strong>Conclusions: </strong>Retropupillary implantation of an iris clip IOL with pars plana vitrectomy is an efficient, predictable, and stable surgical option for aphakic eyes without capsular support. Postoperative corneal edema, hyphema, and anterior chamber inflammation are common but usually resolve without the need for further surgical intervention.</p>","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like Peptide-1 Receptor Agonists in the Management of Diabetic Retinopathy.","authors":"Anindya Samanta, Darius D Bordbar, Christina Y Weng, John R Chancellor","doi":"10.1097/IIO.0000000000000541","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000541","url":null,"abstract":"<p><p>Glucagon-like peptide-1 (GLP-1) receptor agonists are a family of drugs, most well known by the third-generation once-weekly subcutaneous semaglutide, that act on the incretin pathway of metabolic, hormonal signaling to modulate pancreatic insulin release, gastric emptying, energy intake, and subjective feelings of satiety. This class of drugs' efficacy and safety in the treatment of type 2 diabetes and obesity have been demonstrated across multiple large randomized controlled trials. These data have propelled GLP-1 receptor agonists to ubiquity in diabetic management and weight loss therapy, leading them to be frequently encountered in ophthalmic practice. The effect of GLP-1 receptor agonists like semaglutide on diabetic retinopathy (DR) is at this point unclear; some studies indicate a worsening of DR with the initiation of GLP-1 agonists, especially semaglutide. Overall, the macrovascular reduction of cardiovascular and stroke risks from GLP-1 receptor agonists should be prioritized over the potential microvascular progression of DR, as long as the patient is regularly followed by ophthalmology.</p>","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"23-26"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877143","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":"Use of Home Optical Coherence Tomography for Retinal Diseases.","authors":"Darius D Bordbar, Anshul Bhatnagar, Christina Y Weng","doi":"10.1097/IIO.0000000000000546","DOIUrl":"https://doi.org/10.1097/IIO.0000000000000546","url":null,"abstract":"<p><p>Modern treatment protocols for retinal diseases involve frequent in-office monitoring with optical coherence tomography (OCT) and treatment with anti-vascular endothelial growth factor injections. Monthly injections may yield the greatest visual outcomes but are the most burdensome for patients and physicians, while as-needed injections may lead to undertreatment. Hybrid protocols, such as treat-and-extend (TREX) have been conceived to bridge this gap. Device-based home monitoring protocols for retinal disease may iterate further and allow more precise treatment tailored to individualized disease activity curves. Prior non-OCT home monitoring strategies have been developed with varying efficacy. These range from the ubiquitous but low-sensitivity Amsler grid to recent innovations such as the ForeseeHome preferential hyperacuity perimeter. Most recently, home OCT devices have been studied for remote monitoring, largely for use with age-related macular degeneration (AMD). Currently, the only Food and Drug Administration (FDA) approved device that utilizes OCT for monitoring retinal disease is the SCANLY Home OCT. Paired with an artificial intelligence (AI) algorithm that allows automated monitoring and alerting of retinal fluid volumes in AMD, SCANLY has demonstrated feasibility in limited trials to date, and a multicenter randomized controlled trial is currently underway to assess its efficacy in comparison to TREX regimens. Additional non-FDA-approved devices are being developed with varying degrees of study to date. Questions remain regarding its efficacy, real-world implementation, and financial considerations; nevertheless, home OCT has the potential to address many current barriers in retinal care, including travel and treatment burdens, while facilitating increased treatment precision.</p>","PeriodicalId":14338,"journal":{"name":"International Ophthalmology Clinics","volume":"65 1","pages":"41-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877272","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}