Seminars in Ophthalmology最新文献

{"title":"Nodulo-Ulcerative Ocular Surface Squamous Neoplasia in 27 Patients: Clinical Presentation, Management and Outcomes.","authors":"Vijitha S Vempuluru, Anshika Luthra, Prerna Sinha, Suneetha Gavara, Swathi Kaliki","doi":"10.1080/08820538.2024.2432908","DOIUrl":"10.1080/08820538.2024.2432908","url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical presentation, management, and outcomes of nodulo-ulcerative ocular surface squamous neoplasia (nuOSSN).</p><p><strong>Methods: </strong>Retrospective interventional clinical cohort study of 27 patients from a quaternary ocular oncology center.</p><p><strong>Results: </strong>Twenty-seven patients were diagnosed with nuOSSN during the six-year study period. The mean age at presentation was 53 years (median, 51 years; range, 25 to 81 years). Misdiagnosis was noted in 7 (26%) patients, and the mean lag time from symptom onset to presentation at our center was 14 months (median, 6 months; range, 1 to 96 months). The bulbar conjunctiva was the commonest epicenter (<i>n</i> = 19, 70%), and the temporal quadrant was most commonly involved (<i>n</i> = 13, 48%). The mean tumor diameter and thickness were 18 mm (median, 16 mm; range, 8 to 60 mm) and 3 mm (median, 2 mm; range, 1 to 5 mm), respectively. Corneal, limbal, and scleral thinning were seen in 15 (56%), 18 (67%), and 10 (37%) patients, respectively. Peripheral corneal opacification was seen in 18 (67%), and thickening around the area of scleral thinning was seen in 12 (44%) patients. Tumors belonged to the American Joint Committee for Cancer classification T2 (<i>n</i> = 2, 7%), T3 (<i>n</i> = 19, 70%), and T4 (<i>n</i> = 6, 22%) categories. Primary treatment (<i>n</i> = 19) included topical 1% 5-fluorouracil (5FU) eye drops (<i>n</i> = 1, 4%), excisional biopsy (<i>n</i> = 4, 14%), extended enucleation (<i>n</i> = 11, 41%), and orbital exenteration (<i>n</i> = 3, 11%). At a mean follow-up of 9 months (median, 3 months; range 1 to 46 months) in 19 patients who received treatment, the outcomes included local tumor recurrence in 2 patients (11%), tumor control in 16 (84%), globe salvage in 3 (16%), and lymph node metastasis in 2 patients (11%).</p><p><strong>Conclusion: </strong>nuOSSN is an aggressive form of the disease that is frequently misdiagnosed due to the presence of corneoscleral thinning. Globe salvage rates are poor owing to the advanced stage of presentation.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751602","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":"Ocular Immune-Related Adverse Events Associated with PD-1 Inhibitors: From Molecular Mechanisms to Clinical Management.","authors":"Yuqi Gong, Yushuai Liu, Fagang Jiang, Xinghua Wang","doi":"10.1080/08820538.2024.2433636","DOIUrl":"https://doi.org/10.1080/08820538.2024.2433636","url":null,"abstract":"<p><p><b>Purpose:</b> To help ophthalmologists and oncologists better understand the ocular irAEs secondary to PD-1 inhibitors , enabling early detection and management of ocular complications.<b>Methods:</b> We reviewed case reports and related literatures on ocular irAEs secondary to PD-1 inhibitors in PubMed, including a total of 70 case reports, summarizing and analyzing the specific conditions of these patients.<b>Results:</b> The most common malignant tumors were melanoma (<i>n</i> = 41; 58.6%) and lung cancer (<i>n</i> = 13; 18.6%). The main PD-1 inhibitors used were pembrolizumab (<i>n</i> = 38; 54.3%) and nivolumab (<i>n</i> = 28; 40%). They may result in various ocular complications, with the most common being uveitis (<i>n</i> = 35; 50%) and myasthenia gravis (<i>n</i> = 13; 18.57%). Adverse events concerning the cornea and the retina were reported in 8 cases each (11.43%). Neuro-ophthalmic adverse events were reported in 6 cases (8.57%). Most of these toxicities responded to topical and systemic steroids. Severe manifestations, however, may require temporary or permanent cessation of PD-1 inhibitors treatment.<b>Conclusions:</b> With the increasing use of PD-1 inhibitors, ophthalmologists need to remain sensitive to the clinical manifestations of adverse events to ensure timely diagnosis and management. To improve their quality of life and reduce mortality, oncologists and ophthalmologists should maintain close cooperation and implement multi-disciplinary treatment.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-18"},"PeriodicalIF":1.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740428","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 26: Doyens of Dacryology Series - George Brian Bartley (1955-).","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2024.2435695","DOIUrl":"https://doi.org/10.1080/08820538.2024.2435695","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732474","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":"Non-Conditional and Conditional Metastasis of Uveal Melanoma Per Millimeter-By-Millimeter in Thickness in 8034 Patients.","authors":"Hidayet Sener, Rolika Bansal, Thomas Catapano, Jerry A Shields, Carol L Shields","doi":"10.1080/08820538.2024.2432907","DOIUrl":"https://doi.org/10.1080/08820538.2024.2432907","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the impact of uveal melanoma thickness on patient survival from the date of presentation and at specific time intervals following metastasis-free survival.</p><p><strong>Methods: </strong>In this retrospective cohort study, we evaluated data from 8034 consecutive uveal melanoma patients diagnosed at a tertiary care ocular oncology center between May 1972 and August 2007. The patients were categorized on the basis of tumor thickness (per each 1-mm increment) and evaluated for non-conditional survival (from date of presentation) and conditional survival (with 3-years, 5-years, and 10-years of metastasis-free survival) on the cumulative incidence of melanoma-related metastasis at 5-, 10-, 15-, 20-, 25- and 30-years.</p><p><strong>Results: </strong>For the entire cohort, Non-conditional incidence of metastasis at 5-, 10-, 15-, and 30-years was 8%, 11%, 12%, and 12%. Conditional cumulative incidence of metastasis with 5-year and 10-year metastasis-free survival revealed 30-year incidence of metastasis at 10% and 8%, respectively. The multivariate Cox regression analysis showed that each 1-mm increase in tumor thickness was associated with a significant (<i>p</i> < .05) increase in the risk of metastasis [HR: 1.08 (95% CI: 1.05-1.11) for non-conditional survival, HR: 1.07 (95% CI: 1.03-1.11) for 3-year metastasis-free survival, HR: 1.09 (95% CI: 1.03-1.15) for 5-year metastasis-free survival, and HR: 1.17 (95% CI: 1.05-1.30) for 10-year metastasis-free survival].</p><p><strong>Conclusion: </strong>In this study, we emphasize that increasing the thickness of uveal melanoma at presentation demonstrates a poorer ultimate prognosis. However, those with longer metastasis-free intervals were found to have a lower risk of ultimate metastatic disease, highlighting the importance of conditional and non-conditional survival.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710975","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":"Leveraging Artificial Intelligence for Diabetic Retinopathy Screening and Management: History and Current Advances.","authors":"Ramachandran Rajalakshmi, Thyparambil Aravindakshan PramodKumar, Abdul Subhan Naziyagulnaaz, Ranjit Mohan Anjana, Rajiv Raman, Suchetha Manikandan, Viswanathan Mohan","doi":"10.1080/08820538.2024.2432902","DOIUrl":"https://doi.org/10.1080/08820538.2024.2432902","url":null,"abstract":"<p><strong>Aim: </strong>Regular screening of large number of people with diabetes for diabetic retinopathy (DR) with the support of available human resources alone is a global challenge. Digital health innovation is a boon in screening for DR. Multiple artificial intelligence (AI)-based deep learning (DL) algorithms have shown promise for accurate diagnosis of referable DR (RDR). The aim of this review is to evaluate the use of AI for DR screening and the various currently available automated DR detection algorithms.</p><p><strong>Methods: </strong>We reviewed articles published up to May 15th 2024, on the use of AI for DR by searching PubMed, Medline, Embase, Scopus, and Google Scholar using keywords like diabetic retinopathy, retinal imaging, teleophthalmology, automated detection, artificial intelligence, deep learning and fundus photography.</p><p><strong>Results: </strong>This narrative review, traces the advent of AI and its use in digital health, the key concepts in AI and DL algorithm development for diagnosis of DR, some crucial AI algorithms that have been validated for detection of DR and the benefits and challenges of use of AI in detection and management of DR. While there are many approved AI algorithms that are in use globally for DR detection, IDx-DR, EyeArt, and AEYE Diagnostic Screening (AEYE-DS) are the algorithms that have been approved so far by USFDA for automated DR screening.</p><p><strong>Conclusion: </strong>AI has revolutionized screening of DR by enabling early automated detection. Continuous advances in AI technology, combined with high-quality retinal imaging, can lead to early diagnosis of sight-threatening DR, appropriate referrals, and better outcomes.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710974","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":"Susac Syndrome: A Multidisciplinary Approach to Diagnosis and Management with an Emphasis on Ophthalmic Involvement.","authors":"Oliwia Kamieniecka","doi":"10.1080/08820538.2024.2432904","DOIUrl":"https://doi.org/10.1080/08820538.2024.2432904","url":null,"abstract":"<p><strong>Background: </strong>Susac syndrome is a rare autoimmune microangiopathy that affects the small vessels of the retina, brain, and inner ear, leading to a characteristic triad of encephalopathy, branch retinal artery occlusions, and sensorineural hearing loss. The syndrome often presents diagnostic challenges due to its overlapping symptoms with other conditions. Immunosuppressive therapies remain the cornerstone of treatment.</p><p><strong>Methods: </strong>A retrospective review of the literature from PubMed (1998-2024).</p><p><strong>Results: </strong>Special emphasis is placed on the role of ophthalmologists, who play a pivotal role in the diagnostic process. This article provides a comprehensive overview of the disease, focusing on the pathogenesis, clinical presentation, diagnostic process, and treatment approaches.</p><p><strong>Conclusion: </strong>By highlighting the role of ophthalmologists in recognizing and managing Susac Syndrome, this review underscores the importance of a multidisciplinary approach to improve outcomes in this complex, multisystem disease.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688687","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":"Tear Film and Dry Eye Characteristics as Predictors of Photophobia in 374 Patients with Dry Eye Disease.","authors":"Swati Singh, Moumi Maity, Md Hasnat Ali, Sayan Basu","doi":"10.1080/08820538.2024.2429630","DOIUrl":"https://doi.org/10.1080/08820538.2024.2429630","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the tear film parameters associated with photophobia in dry eye disease (DED).</p><p><strong>Methods: </strong>Three hundred seventy-four patients with DED (mean age, 42.2 ± 12.8 years) had their tear film and OSDI scores evaluated using Oculus keratograph 5 M (TMH, NIBUT, Meibography), Lipiview interferometer (LLT), and TearLab osmolarity system. Photophobia scoring from OSDI sheets was used to calculate the odds ratio via multivariate logistic regression analysis. Data from the eye with severely affected NIBUT was used.</p><p><strong>Results: </strong>Of 374, 127 had aqueous deficient dry eye disease (ADDE), and 247 had evaporative DED. The mean age, female sex, Schirmer I, TMH, NIBUT, LLT, and tear osmolarity values in patients with photophobia versus no or mild photophobia were 42.2. vs. 40.9 years, 42% vs. 40%, 11.6 vs. 10.5 mm, 0.27 vs. 0.29 mm, 4.6 vs. 4.7s, 60.3 vs. 60.9 nm and 305 vs. 307 mOsm/L, respectively. Multivariate analysis revealed no tear film parameters predictive of photophobia in evaporative DED, whereas tear osmolarity had a weak negative association with photophobia (odds ratio of 0.96, 95% C.I, 0.92-1, <i>p</i> = .04) in ADDE patients.</p><p><strong>Conclusion: </strong>Tear film parameters do not predict the presence or absence of photophobia in DED except for a weak inverse association with tear osmolarity in ADDE. This suggests the role of central sensitization in regulating photophobia in DED patients.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676247","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":"Risk Factors for Eye and Orbital Injuries Related to Electric Scooters and Off-Road Vehicles.","authors":"Samantha A McLaughlin, Natalia Davila, Niloufar Bineshfar, Tejus Pradeep","doi":"10.1080/08820538.2024.2429633","DOIUrl":"https://doi.org/10.1080/08820538.2024.2429633","url":null,"abstract":"<p><strong>Purpose: </strong>Electric scooters (e-scooters) have rapidly become a mainstream method of transportation in the U.S. but there is consequently limited data on their safety profile. This study evaluates ophthalmic injuries related to e-scooters compared to non-motorized scooters and off-road vehicles (ORV).</p><p><strong>Methods: </strong>This retrospective study uses the National Electronic Injury Surveillance System (2014 to 2023). Ocular injury profiles associated with conventional scooters, e-scooters, and off-road vehicles were included.</p><p><strong>Results: </strong>E-scooter ocular injuries rose by 1950% between 2014 and 2023. E-scooter riders were 4.3 times more likely to sustain orbital fractures and 2.7 times more likely to be hospitalized than non-motorized scooter riders. ORV and e-scooter riders had comparable injury and hospitalization patterns. Alcohol use and lack of helmet use were significant contributors to injury severity.</p><p><strong>Conclusions and relevance: </strong>Injury patterns and hospitalization rates in e-scooter accidents resemble those of ORV incidents. Findings highlight the need for public health interventions to reduce the burden of e-scooter-related injuries.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639708","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 VII: Doyens of Dacryology Series - The Contributions from the Anatomical School of Padua: Andreas Vesalius, Gabriele Falloppio, and Giovanni Battista Morgagni.","authors":"Mohammad Javed Ali","doi":"10.1080/08820538.2024.2429863","DOIUrl":"10.1080/08820538.2024.2429863","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627707","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":"Recent Progression of Pathogenesis and Treatment for Diabetic Cataracts.","authors":"Yike Li, An-Peng Pan, A-Yong Yu","doi":"10.1080/08820538.2024.2427789","DOIUrl":"https://doi.org/10.1080/08820538.2024.2427789","url":null,"abstract":"<p><p><b>Background:</b> Cataracts are still the main cause of blindness worldwide. The incidence of cataracts in the diabetic population is 3-5 times higher than in healthy people. With the increasing incidence of diabetes and the development of aging, as well as the higher risk of surgical and postoperative complications of diabetic patients undergoing surgery, it is still necessary to study the occurrence and development mechanism of diabetic cataracts as well as potential therapeutic targets and therapeutic drugs.<b>Methods:</b> A retrospective review of the literature from PubMed (2017-2024).<b>Results:</b> We summarized the the current literature on the molecular mechanism and prevention and treatment of diabetic cataracts.<b>Conclusions:</b> The aqueous humor metabolism changes, oxidative stress, reactive oxygen species generation increase, the conversion of polyol pathway, as well as non-coding RNA expression changes play important roles in diabetic cataract and these processes is closely linked with each other. Inhibitors or drugs target to these processes, such as aldose reductase inhibitors, antioxidants, natural flavonoid compounds, as well as nanotechnology-based therapeutic product, have shown promising prospects in the prevention and treatment of diabetic cataract.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627710","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}