Seminars in Ophthalmology最新文献

{"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}

{"title":"Uveal Effusion Syndrome Temporally Associated with Primary COVID-19 Infection.","authors":"Neeket R Patel, Marko Oydanich, Larry Frohman, Albert S Khouri","doi":"10.1080/08820538.2024.2381771","DOIUrl":"10.1080/08820538.2024.2381771","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of uveal effusion syndrome in association with primary COVID-19 infection to share our experience and insight in diagnosing and managing this unique case.</p><p><strong>Case presentation: </strong>A 56-year-old woman presented with angle closure glaucoma of both eyes. Further examination and imaging revealed the etiology to be related to bilateral uveal effusions and choroidal thickening in the setting of recent COVID-19 infection. The patient's glaucoma was managed with bilateral iridotomies and medical therapy, while the precipitating uveal effusions resolved with treatment on oral steroids.</p><p><strong>Conclusion: </strong>While uveal effusion syndrome has been associated with COVID-19 vaccination, it has not yet been reported after primary infection. Recognition of this rare phenomenon will allow for better diagnosis and treatment in future cases.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"143-145"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752633","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":"Frosted Branch Angiitis After COVID-19.","authors":"Kayo Sugiura, Ken Fukuda, Rika Shoji, Mayu Kadono, Kenji Yamashiro","doi":"10.1080/08820538.2024.2399117","DOIUrl":"10.1080/08820538.2024.2399117","url":null,"abstract":"","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"146-148"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133669","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":"Topical Chloramphenicol in Ophthalmology: Old is Gold.","authors":"Malik Moledina, Bhupendra C K Patel, Raman Malhotra","doi":"10.1080/08820538.2024.2381772","DOIUrl":"10.1080/08820538.2024.2381772","url":null,"abstract":"<p><strong>Purpose: </strong>Topical chloramphenicol is one of the most ubiquitous antibiotics used in ophthalmology and oculoplastic surgery globally. It shows broad-spectrum activity against a variety of different pathogenic organisms, is well tolerated on the ocular surface and displays excellent topical pharmacokinetics. Chloramphenicol has been available for purchase over the counter in the United Kingdom since 2005. Despite this, the largest health economy in the world, The United States has had a de-facto moratorium on its use for the past 30 years. In this review, we aim to evaluate topical chloramphenicol in ophthalmology and oculoplastic surgery and to determine whether its reputation within the US is warranted and justified.</p><p><strong>Methods: </strong>We conducted a comprehensive literature review to evaluate the different facets of chloramphenicol, providing a detailed understanding of the drug, its historical context, the benefits and perceived risks, including safety concerns, and clinical perspectives of its use in clinical practice.</p><p><strong>Results: </strong>The mechanism of chloramphenicol, the context around which the drug's use in the US declined, and the drug's evidence base and safety data, including published case reports of serious adverse events, were analysed. The perceived benefits of the drug, particularly in light of antimicrobial resistance and its economic impact, were reviewed. Finally, perspectives on its use in clinical practice in ophthalmology and associated allied specialities were presented.</p><p><strong>Conclusion: </strong>Chloramphenicol and its topical application have been misunderstood for many decades, particularly in the United States. Its demise across the Atlantic was due to an overzealous response to a dubious association with a weak evidence base. Numerous authors have since validated the safety profile of the and its safety has been borne out. The benefits of chloramphenicol, an effective broad-spectrum agent with a positive cost differential in the era of anti-microbial resistance and fiscal tightening, cannot be understated. Its likely effectiveness as a therapeutic topical agent in ophthalmic surgery makes it a valuable tool in the ophthalmic anti-microbial armoury. We would encourage the reinstatement of this valuable yet misunderstood drug as a first-line agent for simple ophthalmic infections.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"97-106"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760837","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":"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":"The Association Between Blepharitis and Lower Eyelid Ectropion in a Large Cohort of Patients.","authors":"Lital Smadar, Noa Kapelushnik, Guy J Ben-Simon, Shlomo Segev, Shahar Soudry, Amir Abd-Elkader, Daphna Landau Prat","doi":"10.1080/08820538.2025.2459311","DOIUrl":"https://doi.org/10.1080/08820538.2025.2459311","url":null,"abstract":"<p><strong>Purpose: </strong>Blepharitis and lower eyelid ectropion are highly prevalent ocular conditions occurring in 37%-46% and 2-3% of the general adult population, respectively. Blepharitis has multifactorial origins and involves anterior and posterior types of eyelid inflammation. Lower eyelid ectropion results in ocular surface exposure, epiphora and chronic conjunctivitis. This study aims to investigate any possible association between both conditions.</p><p><strong>Methods: </strong>Medical records of 37,692 consecutive patients examined at a single medical screening center between 2001-2020 were retrospectively analyzed.</p><p><strong>Main outcome measures: </strong>The prevalence of lower eyelid ectropion and of blepharitis, a possible association between the two, and the relation of each to age and sex.</p><p><strong>Results: </strong>A total of 35,670 patients were included. Ectropion was diagnosed in 69 patients (0.2%), and blepharitis in 4725 patients (13.2%). Male sex was more prevalent for each pathology (88.4% ectropion, and 85% blepharitis, <i>p</i> < .001). Older age was associated with each diagnosis (77.3 years for ectropion patients vs. 52.2 years for the general screened population and 60.5 years for blepharitis patients vs 52.2 years for the general screened population <i>p</i> < .001). The prevalence of ectropion was significantly higher in patients with coexisting blepharitis compared to those without (0.8% vs. 0.1%, respectively, <i>p</i> < .001).</p><p><strong>Conclusions: </strong>Ectropion was significantly more prevalent in patients with blepharitis. Both conditions were associated with older age and male sex. This coexistence can aid in decision making of early surgical intervention of lower eyelid ectropion as well as the approach to medical treatment of blepharitis.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-5"},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067794","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}