Seminars in Ophthalmology最新文献

{"title":"Phacoemulsification with Either Endocyclophotocoagulation or Ab-Interno Canaloplasty with or without Trabeculotomy in Uveitic Glaucoma.","authors":"Helena Lam, Nathaniel P Miller, Joshua H Olson, Justin J Yamanuha","doi":"10.1080/08820538.2024.2405730","DOIUrl":"10.1080/08820538.2024.2405730","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding the current role and efficacy of endocyclophotocoagulation (ECP) compared to ab-interno canaloplasty with or without trabeculotomy (OMNI), combined with cataract extraction and lens implantation (CEIOL), for the management of uveitic glaucoma (UG) is limited.</p><p><strong>Methods: </strong>All UG patients ≥18 years old with ≥6 months of follow-up data (15.2 ± 5.9 months) after CEIOL combined with either ECP or OMNI from August 2019 to May 2022 at a single academic center were retrospectively reviewed [22 eyes of 15 patients (8 ECP, 14 OMNI)]. Surgical success was considered intraocular pressure (IOP) ≤21 mmHg and a reduction of baseline by ≥20% for two consecutive final visits without hypotony, additional surgery, or loss of light perception. Uveitic control was considered a <2-step increase in anterior chamber (AC) cell grade, <3+ AC cell grade, and no increase in steroid drop use at 3 months postoperatively. Secondary outcome measurements included postoperative change in IOP, glaucoma medications, best corrected visual acuity (VA), AC cell grade, and steroid drop frequency.</p><p><strong>Results: </strong>Baseline ocular and preoperative characteristics of eyes (age, sex, laterality, uveitic location, systemic immunomodulating therapy, visual acuity, IOP, number of glaucoma medications, AC cell grade, and steroid drop frequency) did not significantly differ except for greater racial diversity in the ECP group. 62.5% eyes were surgically successful in the ECP group and 85.71% in the OMNI. Between-group analysis showed greater IOP reduction in the OMNI group (<i>p</i> < .05), but no difference in reduction of glaucoma medications (<i>p</i> = .33). No eyes displayed a two-step increase in or >3+ AC cell grade, however, 50% and 64.29%, respectively, increased steroid drop use. Between groups, no difference in the change of AC cell grade (<i>p</i> = .98) or steroid drop use (<i>p</i> = .84) was seen.</p><p><strong>Conclusions: </strong>Both interventions improved visual acuity, IOP, and glaucoma medication use, however, OMNI was more successful at reducing IOP long term. An increase in steroid drop frequency may be the cost of a prolonged post-surgical inflammatory course related to underlying uveitis regardless of surgical approach.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"137-142"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353352","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}

{"title":"Lacrimal Drainage Anomalies in Goldenhar, Rubinstein-Taybi, and Ectodermal-Ectrodactyly-Clefting Syndromes.","authors":"Nandini Bothra, Purva Agarwal, Mohammad Javed Ali","doi":"10.1080/08820538.2024.2355310","DOIUrl":"10.1080/08820538.2024.2355310","url":null,"abstract":"<p><strong>Objective: </strong>To describe in detail the lacrimal drainage system anomalies and review of literature in patients with Goldenhar syndrome, Rubinstein-Taybi syndrome (RTS), and Ectodermal-Ectrodactyly-Clefting syndrome (EECS), their management and outcomes.</p><p><strong>Methods: </strong>A retrospective chart review from January 2011-June 2023 of all cases presenting to the Dacryology clinic with Goldenhar syndrome, RTS, and EECS was obtained. Data collected included demographics, laterality, clinical presentations, proximal and distal lacrimal drainage anomalies, associated systemic features, management, and outcomes.</p><p><strong>Results: </strong>Eight children with Goldenhar syndrome (<i>n</i> = 13), three with RTS (<i>n</i> = 5) and three with EECS (<i>n</i> = 5) presented with lacrimal drainage system involvement. Cases with Goldenhar syndrome showed male predominance (5/8), and the mean age at presentation was 14.75 months. Four cases had simple CNLDO, seven cases with complex CNLDO (4 - buried probe and 3 - atonic sacs) and a single neonate presented with bilateral dacryocele. Patients with RTS presented with mean age of 36.33 months with male predominance. Probing under endoscopic guidance explored the anatomy thoroughly and those with altered nasal anatomy increased the probability of complex CNLDO. Those with EECS (<i>n</i> = 5) presented with a greater involvement of proximal lacrimal drainage system compared with Goldenhar syndrome and RTS, including anomalies like punctal agenesis, incomplete punctal canalization (IPC), ectopic puncta, canalicular stenosis, and complex CNLDO.</p><p><strong>Conclusions: </strong>A step-wise approach to assessing the proximal and lacrimal drainage system in those affected with craniofacial malformations and addressing them can result in satisfactory outcomes for the majority of patients.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"120-127"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076367","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}

{"title":"Lacrimal History - Part IX: Doyens of Dacryology Series - Johann Caspar Schobinger and His Lacrimal Dissertation of 1730.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2024.2414634","DOIUrl":"10.1080/08820538.2024.2414634","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"82-85"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142474220","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}

{"title":"Insights from the First Five Years of the Prospective Ocular Tumor Study.","authors":"Rachel M Malsch, Rachael B Tessem, Lauren A Dalvin","doi":"10.1080/08820538.2025.2457043","DOIUrl":"https://doi.org/10.1080/08820538.2025.2457043","url":null,"abstract":"<p><strong>Purpose: </strong>Standardized data collection is needed to improve research for rare diseases. In this manuscript, we describe our experience establishing the Prospective Ocular Tumor Study (POTS).</p><p><strong>Methods: </strong>The ongoing POTS captures all patients with an ocular tumor seen on the Ocular Oncology Service at Mayo Clinic Rochester and collects patient demographics, tumor features, treatment, and outcomes. This manuscript reports data collected from July 2019-July 2024.</p><p><strong>Results: </strong>During a 5-year time period, 1,766 patients enrolled in the database, with 975 (55%) females, 1,732 (98%) white race, and mean age 61.5 years. The most frequent tumor types were choroidal melanoma (<i>n</i> = 610 [34%]), choroidal nevus (<i>n</i> = 575 [32%]), iris nevus (<i>n</i> = 95 [5.3%]), iris melanoma (<i>n</i> = 46 [2.6%]), and vitreoretinal lymphoma (<i>n</i> = 46 [2.6%]).</p><p><strong>Conclusion: </strong>The POTS is a valuable source of detailed, longitudinal data on rare ocular tumors. Expanding standardized data collection across multiple centers will facilitate improved outcomes research in ocular oncology.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060606","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}

{"title":"Ciliary Body Medulloepithelioma: Clinical and Pathologic Challenges with a Focus on Molecular Genetics.","authors":"Ari H August, Linda A Cernichiaro-Espinosa, Mariana Moctezuma-Davila, Turner D Wibbelsman, Matthew W Wilson, Patricia Chévez-Barrios, Carol L Shields, Sara E Lally, Charles G Eberhart, Brent A Orr, Edward Simpson, Ralph C Eagle, Tatyana Milman","doi":"10.1080/08820538.2025.2457066","DOIUrl":"https://doi.org/10.1080/08820538.2025.2457066","url":null,"abstract":"<p><strong>Objective: </strong>Ciliary body medulloepithelioma (CBME), a pediatric intraocular tumor with potential for locally aggressive behavior and metastasis, may present with a diverse spectrum of clinical and histopathologic features leading to diagnostic and management challenges. Examination of unusual CBME cases highlights challenges and modern diagnostic techniques which facilitate accurate diagnosis and guide management.</p><p><strong>Methods: </strong>A retrospective clinicopathologic analysis of 6 patients with unusual clinical or pathologic features of CBME was performed.</p><p><strong>Results: </strong>The mean duration of delay in accurate diagnosis was 5.7 years (SD: 8.2, median: 3, range: 0-22). All patients developed cataract, 4 (67%) were diagnosed with glaucoma, and 4 (67%) underwent surgery prior to accurate diagnosis. At initial presentation, only one patient with a known history of genetically confirmed DICER1 syndrome underwent appropriate imaging leading to a timely identification of a ciliary body mass and no delay in diagnosis. Following identification of intraocular mass, 4 (67%) patients underwent enucleation. Two patients (33%) underwent exenteration for extraocular extension of CBME. Initial histopathologic differential diagnosis included CBME, melanoma, adenoma or adenocarcinoma of the pigmented ciliary body epithelium, retinoblastoma, sarcoma, and malignant teratoma. Immunohistochemistry and genetic testing assisted in the diagnosis of CBME. Two patients (33%) had a germline DICER1 variant; this was known prior to CBME diagnosis in one patient and discovered after CBME diagnosis in the second patient.</p><p><strong>Conclusion: </strong>This series highlights the unusual clinical and histopathologic features of CBME that contribute to delays in diagnosis. Modern aids including genetic testing, ancillary imaging studies, and immunohistochemistry facilitate a timely accurate diagnosis of CBME and guide management.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047675","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}

{"title":"Lacrimal History - Part 35: Doyens of Dacryology Series - Friedrich Paul Paulsen (1965-).","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2025.2459481","DOIUrl":"https://doi.org/10.1080/08820538.2025.2459481","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041807","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}

{"title":"A Survey of the Congenital Glaucoma Surgery Practice Patterns in the Indian Pediatric Glaucoma Society.","authors":"Anil K Mandal, Zayn Al-Timimi, Vijaya K Gothwal, Sushmita Kaushik, Sirisha Senthil, Viney Gupta, Shanta Balekudaru, Suneeta Dubey, Manju R Pillai","doi":"10.1080/08820538.2025.2457590","DOIUrl":"https://doi.org/10.1080/08820538.2025.2457590","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the practice patterns among the Indian Pediatric Glaucoma Society (IPGS) members in the management of children with primary congenital glaucoma (PCG).</p><p><strong>Methods: </strong>An anonymous 74-question survey was administered online via Qualtrics (Qualtrics, Provo, Utah, USA) using a link sent by email to the 88 IPGS members. The questionnaire comprised five sections and was designed to gather information regarding respondent demographics and specialty training, clinic composition and volume, surgical practices and preferences, follow-up practices, and additional services. The survey was closed after 10 weeks. Data were analyzed using descriptive statistics and Chi-square tests. Statistical significance was set at <i>p</i> < .05.</p><p><strong>Results: </strong>The response rate was 82%. Of the 71 respondents, 49 (69%) reported possessing glaucoma fellowship training that included specialist training in pediatric glaucoma. By comparison, 8 respondents (11%) reported possessing pediatric ophthalmology fellowship training that included specialist training in pediatric glaucoma, and this difference was statistically significant (69% <i>vs</i>. 11%; χ² = 47.37; <i>p</i> < .0001). The majority of the respondents were in ophthalmic institution-based practice (83%) and were located in South India (58%). In cases of hazy cornea, the most common surgery (95%) performed was combined trabeculotomy-trabeculectomy while goniotomy was most preferred (49%) in cases of clear cornea. Approximately, one-half of the respondents (56%) preferred to operate on each eye in separate sessions, whereas 46% preferred to operate on both eyes in the same session. One-half of the respondents (51%) preferred to use mitomycin-C in primary surgery. The most common challenges in providing care were patient-related, including delayed presentation, high travel costs, and low socioeconomic status.</p><p><strong>Conclusions: </strong>Although a substantial consensus was found in most areas of management, a few areas, for example, use of MMC in primary surgery, showed diversity. The information gathered will enable glaucomatologists to compare their practices with those of their colleagues. In addition, this survey provides a baseline, allowing future trends in management to be determined.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024391","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}

{"title":"Lacrimal History - Part 36: Doyens of Dacryology Series - Michael McDonogh.","authors":"Mohammad Javed Ali, Peter John Wormald","doi":"10.1080/08820538.2025.2452088","DOIUrl":"https://doi.org/10.1080/08820538.2025.2452088","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024437","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}

{"title":"Asymmetric Intraocular Pressure Changes in Dominant and Contralateral Eyes: The Dark Room Prone Provocative Test.","authors":"Junwei Wang, Jun Wang, Tsz Kin Ng, Chukai Huang","doi":"10.1080/08820538.2024.2443972","DOIUrl":"https://doi.org/10.1080/08820538.2024.2443972","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate changes in intraocular pressure (IOP) in dominant and contralateral eyes following the dark room prone provocative test (DRPPT) in the study subjects with shallow anterior chamber.</p><p><strong>Methods: </strong>This was a prospective, single-center, non-randomized controlled trial of 43 subjects (86 eyes) with shallow anterior chamber. The dominant eye was identified using the card-hole method. The study subjects underwent the DRPPT for one hour. Pre- and post-DRPPT IOP was measured using an I-Care tonometer, and pupillary parameters, including amplitude of constriction, peak constriction velocity, and peak re-dilation velocity, were also measured using the RAPDx® dynamic pupillometer.</p><p><strong>Results: </strong>Significant increases in IOP were observed in both the dominant and contralateral eyes after DRPPT, compared to their respective pre-DRPPT IOP levels. (<i>p</i> < .01). Moreover, IOP variation before and after DRPPT was significantly greater in the dominant eye than in the contralateral eye (median 3.60 mmHg vs. 2.70 mmHg, <i>p</i> < .05). The dominant eyes exhibited a smaller amplitude of constriction (1.07 ± 0.35 mm vs 1.14 ± 0.34 mm, P < .05) and slower constriction velocity (3.71 ± 1.12 mm/s vs 3.78 ± 1.11 mm/s, P < .05) as compared to the contralateral eyes.</p><p><strong>Conclusions: </strong>This study demonstrated that the dominant eye exhibited greater IOP changes after DRPPT than the contralateral eye. Additionally, it showed smaller pupil constriction and slower contraction, indicating a higher likelihood of pupil blockage in the dominant eye with shallow anterior chambers. This asymmetry partially explains the monocular onset of acute angle-closure attacks.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024395","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}

{"title":"Complications After Incisional/Excisional Minimally Invasive Glaucoma Surgery-An Update and Literature Review.","authors":"Aparna Rao, Manikanta Damagantla, Rashmi Krishnamurthy, Sirisha Senthil","doi":"10.1080/08820538.2025.2450687","DOIUrl":"https://doi.org/10.1080/08820538.2025.2450687","url":null,"abstract":"<p><strong>Purpose: </strong>To discuss comprehensively the varied complications after stent-less incisional or excisional minimally invasive glaucoma surgery (MIGS).</p><p><strong>Method: </strong>A review of reported complications after stent-less MIGS procedures including gonioscopy-assisted transluminal trabeculotomy (GATT), bent needle goniectomy (BANG), Kahook-dual blade goniotomy, and microincisional trabeculectomy (MIT) published between 2014-2024, were analyzed and summarized.</p><p><strong>Results: </strong>Apart from hyphema, peripheral anterior synechiae, and intraocular pressure spikes, other vision-threatening complications like cyclodialysis, Descemet's detachment, corneal edema, iridodilalysis, vitreous loss or vitreous hemorrhage can also occur intra- or postoperatively after any incisional or excisional MIGS procedures.</p><p><strong>Conclusion: </strong>All possible complications are to be kept in mind during MIGS despite the procedures being minimally invasive. Adequate care should be taken during different stages of the surgery to avoid these complications.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011060","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}