Seminars in Ophthalmology最新文献

{"title":"Evaluation of the Efficacy and Safety of Preoperative Intravitreal Triamcinolone Acetonide Combined with Internal Limiting Membrane Peeling for the Treatment of Idiopathic Macular Epiretinal Membrane.","authors":"Jie Wang, Yuyan Liu, Yanhua Chu, Guoge Han, Quanhong Han","doi":"10.1080/08820538.2025.2463999","DOIUrl":"https://doi.org/10.1080/08820538.2025.2463999","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy and safety of preoperative intravitreal triamcinolone acetonide (IVTA) combined with internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (IMEM).</p><p><strong>Methods: </strong>This was a retrospective study. Thirty-six phakic eyes of 35 patients were included in this study. IVTA was administered to 18 patients (18 eyes, Group IVTA) 7 days before vitrectomy, while the other 17 patients (18 eyes, Group no-IVTA) only underwent vitrectomy and ILM peeling. Patients were followed up for at least 6 months. Data on best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), inner retinal thickness (IRT), vascular parameters (measured by optical coherence tomography angiography, OCTA), mean macular sensitivity (MMS), 63% bivariate contour ellipse area (BCEA) and P1 (measured by macular integrity assessment, MAIA) were collected.</p><p><strong>Results: </strong>There were significant differences in BCVA and IRT between the IVTA group and the no-IVTA group at 6 months after surgery (<i>p</i> = .000 and <i>p</i> = .010). The CMT and MMS of the two groups significantly changed from the preoperative values; however, there were no differences between the 2 groups during the entire study period (<i>p</i> = .242 and <i>p</i> = .849). The changes in vascular parameters, including foveal avascular zone (FAZ) area and vessel densities of superficial and deep capillary plexus (SCP VD and DCP VD), in the two groups were not statistically significant. There were no statistically significant differences in 63% BCEA and P1 either.</p><p><strong>Conclusion: </strong>Macular morphology and macular integrity improved after vitrectomy combined with ILM peeling surgery. Compared with the no-IVTA group, preoperative intravitreal triamcinolone acetonide can improve best corrected visual acuity and accelerate the absorption of intraretinal fluid in terms of a significant reduction in IRT.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374605","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":"Syncope in the Ophthalmology Outpatient Department.","authors":"James Pietris, Stephen Bacchi, Arthas Flabouris, WengOnn Chan","doi":"10.1080/08820538.2025.2464003","DOIUrl":"https://doi.org/10.1080/08820538.2025.2464003","url":null,"abstract":"<p><strong>Introduction: </strong>Syncope is a clinical symptom that occurs commonly in all medical facilities, including the ophthalmology outpatient department. A broad differential diagnosis exists for syncope, of which vasovagal syncope is the most common.</p><p><strong>Results: </strong>Efficient recognition and management of syncope in the ophthalmology department is essential to minimise its economic and time cost to patients, staff and the healthcare system.</p><p><strong>Conclusions: </strong>We propose a three-step approach to managing syncope for ophthalmology staff consisting of risk factor identification, preventative strategies and appropriate initial management to triage patients effectively and efficiently with minimal disruption to workflow in this inherently busy environment.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365861","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 34: Doyens of Dacryology Series - Juan Murube del Castillo (1934-2024).","authors":"Marco Sales-Sanz, Francisco J Muñoz-Negrete, Mohammad Javed Ali","doi":"10.1080/08820538.2025.2463247","DOIUrl":"https://doi.org/10.1080/08820538.2025.2463247","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190532","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":"Phacofragmentation of Posteriorly Dislocated Lens Fragments: Limbal versus Pars Plana Approach.","authors":"Muhammad M Shamim, Sam Karimaghaei, Riley Sanders, Sami H Uwaydat, Ahmed B Sallam","doi":"10.1080/08820538.2024.2376630","DOIUrl":"10.1080/08820538.2024.2376630","url":null,"abstract":"<p><strong>Purpose: </strong>To assess intra-operative complications and feasibility of removing crystalline lens fragments from the vitreous cavity through a limbal incision compared to a pars plana approach.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Subjects: </strong>16 eyes underwent phacofragmentation via a limbal approach (Group A) and 9 eyes through a pars plana approach (Group B) at an academic center over a 10-year period.</p><p><strong>Methods: </strong>We collected pre-operative, intra-operative, and post-operative data. We compared rates of intraoperative complications, including corneal wound burn, iris or capsular damage, retinal tears, and hemorrhage, and recorded post-operative BCVA and IOP measurements at the one-month post-operative appointment. We also compared rates of post-operative complications, including corneal edema, choroidal detachment, or retinal detachment.</p><p><strong>Main outcome measures: </strong>Primary outcomes of the study were the rates of intraoperative complications and the feasibility of crystalline lens removal with the limbal approach. We defined the latter outcome as the ability to complete lens removal without switching to the pars plana route.</p><p><strong>Results: </strong>Mean BCVA for group A was 1.6, and for group B was 2.0 (<i>p</i> = .19). There was no significant difference between the two groups in the incidence of intraoperative complications, including corneal wound burn, iris damage, anterior capsular tear, iatrogenic retinal tear, or suprachoroidal hemorrhage (<i>p</i> > .99). There was no significant difference in the incidence of intra-operative vitreous hemorrhage (<i>p</i> = .36). Additionally, there was no significant difference in post-operative corneal edema (<i>p</i> = .27), choroidal detachment (<i>p</i> = .52), or retinal detachment (<i>p</i> > .99). The mean post-operative BCVA was 1.0 in group A and 1.0 in group B (<i>p</i> = .75). We completed all cases in group A using the limbal approach without switching to the pars plana route.</p><p><strong>Conclusion: </strong>Phacofragmentation through a limbal incision provides a feasible option for dropped nuclear fragment removal and is not associated with a higher risk of complications than the pars plana route.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"115-119"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564256","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 VIII: Doyens of Dacryology Series - Lorenz Heister (1683-1758) and His Surgical Treatise.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2024.2400842","DOIUrl":"10.1080/08820538.2024.2400842","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"77-81"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294932","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":"Pediatric Toy-Related Ocular Injuries in the United States: A National Electronic Injury Surveillance System Study.","authors":"Sruti Rachapudi, Mona Kaleem","doi":"10.1080/08820538.2024.2388622","DOIUrl":"10.1080/08820538.2024.2388622","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to evaluate the epidemiological trends, primary ocular diagnosis, and degree of injury severity in pediatric patients after a toy-related ocular trauma.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using data from the National Electronic Injury Surveillance System Study (NEISS), encompassing patients who visited emergency departments over a 5-year period from January 1, 2017, to December 31, 2021, with toy-related ocular injuries. Descriptive statistics were employed using Microsoft Excel.</p><p><strong>Results: </strong>Among the 1439 toy-related ocular injuries identified, the mean age of injury was 6.67 ± 4.36 years. The highest proportion of injuries occurred in the 2-5 years age group (27.2%). The NEISS database classified the severity of injury - the majority of which were minor anterior segment injuries. Toy guns with projectiles were identified as the most common type of toy associated with ocular eye injury. While most injuries were minor, a small percentage was severe.</p><p><strong>Conclusion: </strong>Age-appropriate toy selection and adult supervision during playtime are recommended preventive measures to mitigate the incidence and severity of traumatic eye injuries in children.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"128-131"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894209","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":"Readership Awareness Series - Paper 13: Key Concepts of Translational Research.","authors":"Mohammad Javed Ali, Ali Djalilian","doi":"10.1080/08820538.2024.2392358","DOIUrl":"10.1080/08820538.2024.2392358","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"107-109"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036881","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":"Predictive Value of Conjunctival Cytology in Bleb-dependent Glaucoma Surgery.","authors":"María Parrilla Vallejo, Marina Soto Sierra, Juan José Ríos Martín, Manuel Pérez Pérez, Cristian Cortés Laborda, Antonio Manuel Garrido Hermosilla, Luz Valverde Cano, Enrique Rodríguez de la Rúa Franch","doi":"10.1080/08820538.2024.2391824","DOIUrl":"10.1080/08820538.2024.2391824","url":null,"abstract":"<p><strong>Purpose: </strong>Metaplasia, chronic inflammation and subconjunctival fibrosis favor failure of bleb-dependent glaucoma surgery. The aim of the study is to identify the patients at a higher risk of post-surgical failure.</p><p><strong>Materials and methods: </strong>Prospective, open study, performed in the Glaucoma Unit of the Hospital Universitario Virgen Macarena, from April to November 2021, with a minimum follow-up of one year. 38 eyes with ocular hypertension or chronic open-angle glaucoma were included. All patients underwent preoperative conjunctival sampling in the operating room, under topical or locoregional anesthesia.</p><p><strong>Parameters measured: </strong>Sex, age, and laterality; number, type and mean time of preoperative drugs use; type of surgery performed; cytology results and degree of metaplasia; percentage of patients in whom the bleb was closed. Evaluation of potential correlation between bleb closure and any of the other variables.</p><p><strong>Results: </strong>20 women and 18 men participated, with a mean age of 67 years. The mean number of preoperative hypotensive drugs was 2.7. The mean time of use was 90,97 +/- 48,97 months. Most patients had normal cytology, 8% had inflammatory infiltrate and 21% had squamous metaplasia. When relating bleb failure and cytology, we saw that in those who failed surgery, more than half had cytological alterations. A multiple logistic regression was performed, in which we observed that there was statistically significant association (<i>p</i> = .02) between surgical closure and altered cytology.</p><p><strong>Conclusions: </strong>According to these results, preoperative conjunctival cytology can help predict those cases with a lower probability of surgical success.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"132-136"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081461","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":"Do We Need to Hold Aspirin Before Cataract Surgery? A Systematic Review and Meta-Analysis of 65,196 Subjects.","authors":"Mohamed Abo Zeid, Amr Elrosasy, Ahmad Alkheder, Hazim Alkousheh, Mohammad Al Diab Al Azzawi, Shrouk F Mohamed, Ameen Alkhateeb, Hashem Abu Serhan","doi":"10.1080/08820538.2024.2420969","DOIUrl":"10.1080/08820538.2024.2420969","url":null,"abstract":"<p><strong>Purpose: </strong>Cataract surgery is a common operation, typically carried out on older adults who have many comorbid medical conditions. Many of these patients may be undergoing aspirin therapy for diverse cardiovascular causes. Nevertheless, there is ongoing controversy regarding the administration of aspirin therapy during the perioperative period, as there are concerns regarding the risk of bleeding problems compared to thromboembolic events. Although aspirin is commonly used, there is no agreement on whether to continue or stop taking it before cataract surgery. This systematic review and meta-analysis attempt to assess the safety of continuing or discontinuing aspirin in the setting of cataract surgery.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis following PRISMA guidelines. Four databases were searched until January 25, 2024, for studies assessing the safety and efficacy of aspirin continuation or discontinuation before cataract surgery. The risk ratios (RR) of the extracted data and their 95% confidence interval (95% CI) were pooled using RevMan 5.4 software. We registered our protocol in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42024529986).</p><p><strong>Results: </strong>We included nine studies with a total of 65,196 patients comprising various study designs and global populations. The analysis revealed a significant increase in subconjunctival hemorrhage risk with aspirin continuation (RR: 1.74, 95% CI: 1.22, 2.50, <i>p</i> = .002). However, the risk of hyphema, retrobulbar hemorrhage, vitreous hemorrhage, intraocular pressure spike, corneal edema, posterior capsule rupture, and visual acuity changes did not significantly differ between aspirin continuation and discontinuation or aspirin and placebo groups.</p><p><strong>Conclusion: </strong>Although the use of aspirin before cataract surgery raises the likelihood of subconjunctival bleeding, it does not increase the risk of potentially sight-threatening bleeding events. We recommend continuation of aspirin in patients undergoing cataract surgery.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"86-96"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558721","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":"Learning Curve in Posterior Segment Ophthalmic Diagnostic Endoscopy: Implications for Budding Enthusiasts and Fellows-In-Training.","authors":"Vivek Pravin Dave, Ramya Natarajan, Rajeev Reddy Pappuru","doi":"10.1080/08820538.2024.2373269","DOIUrl":"10.1080/08820538.2024.2373269","url":null,"abstract":"<p><strong>Purpose: </strong>To elucidate the learning curve for posterior segment diagnostic endoscopy (DE) based on the results of a self-trained (ST) and a supervised (SUP) vitreoretinal surgeon.</p><p><strong>Methods: </strong>Retrospective review of medical records of DE performed between 2017 and 2023 by one ST and one SUP vitreoretinal surgeon at a tertiary eye care institute. Data were collected and the serial number of cases was plotted against the time taken for the procedure. A comparative regression plot was created for both the surgeons to know the slope of the learning curve. The start time was noted as that of attachment of the endoscope and the stop time was noted as the end of diagnostic evaluation. Procedures were divided into blocks of 10 cases each and the time taken for the procedures was calculated.</p><p><strong>Results: </strong>Total of 106 eyes (58 by ST surgeon and 48 by SUP surgeon) were included. For ST surgeon, the time taken for the surgery correlated inversely (reduced sequentially) with the serial number of the case till the 20^th case (correlation coefficient = -0.5, <i>p</i> = .01), for SUP surgeon, the time taken for the surgery correlated inversely with the serial number of the case till the 10^th case (correlation coefficient = -0.9, <i>p</i> = <0.0001) and then stabilized. Neither of the groups had any adverse events.</p><p><strong>Conclusion: </strong>About 20 cases for a self-trained and about 10 cases for a supervised vitreoretinal surgeon are required to get stable with DE. These observations have implications in creating a training module for DE with appropriate number of training cases.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"110-114"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141580756","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}