Paolo Forte , Michel Paques , Jennifer Cattaneo , Bénédicte Dupas , Daniela Castro-Farias , Jean-François Girmens , Mehdi Siab , Francesco Biagini , Massimo Nicolò , Chiara Maria Eandi , Riccardo Sacconi , Giuseppe Querques
{"title":"Perifoveal vascular anomalous complex and telangiectatic capillaries: An overview of two entities potentially sharing a common pathophysiology","authors":"Paolo Forte , Michel Paques , Jennifer Cattaneo , Bénédicte Dupas , Daniela Castro-Farias , Jean-François Girmens , Mehdi Siab , Francesco Biagini , Massimo Nicolò , Chiara Maria Eandi , Riccardo Sacconi , Giuseppe Querques","doi":"10.1016/j.survophthal.2025.01.007","DOIUrl":"10.1016/j.survophthal.2025.01.007","url":null,"abstract":"<div><div>Focal capillary ectasia in the macular region can manifest in distinct clinical scenarios, which can be categorized into 2 main entities: perifoveal vascular anomalous complex (PVAC) and telangiectatic capillaries (TelCaps). PVAC represents a primary, idiopathic condition, whereas TelCaps occur secondary to underlying vascular disorders, including diabetic macular edema and retinal vein occlusion. We provide a comprehensive analysis of these 2 entities, encompassing their clinical presentations, multimodal imaging findings, histological evidence, and differential diagnosis from other retinal microvascular abnormalities, such as Type 1 macular telangiectasia, adult-onset Coats disease, Type 3 macular neovascularization in age-related macular degeneration, and retinal arterial macroaneurysms. Although PVAC and TelCaps are distinct entities, they may share common pathogenic mechanisms, including progressive endothelial dysfunction, pericyte loss, and intraluminal deposition of blood components. Selective laser photocoagulation has emerged as a promising therapeutic approach for both conditions. The proposed standardization of nomenclature for accurate reporting and meaningful cross-study comparisons is expected to facilitate future advancements in this field, ultimately leading to improved patient outcomes.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 369-379"},"PeriodicalIF":5.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Extracellular vesicles in dry eye disease and Sjögren’s syndrome: A systematic review on their diagnostic and therapeutic role","authors":"Prakshi Chopra , Asra Fatima , Sonali Mohapatra , Kavipriya Murugaiyan , Geeta K. Vemuganti , Aravind Kumar Rengan , Stephanie L. Watson , Vivek Singh , Sayan Basu , Swati Singh","doi":"10.1016/j.survophthal.2025.01.003","DOIUrl":"10.1016/j.survophthal.2025.01.003","url":null,"abstract":"<div><div>Extracellular vesicles (EVs), defined as membrane-bound vesicles released from all cells, are being explored for their diagnostic and therapeutic role in dry eye disease (DED). We systematically shortlisted 32 articles on the role of EVs in diagnosing and treating DED. We cover the progress in the last 2 decades on the classification and isolation of EVs and their role in DED. The diagnostic predictability of exosomes was evaluated in Sjögren syndrome (SS) patients' tears, plasma, and saliva, where upregulation of inflammatory proteins was reported uniformly across studies. Also, we evaluate the therapeutic effects of MSC-derived EVs in <em>in vitro</em> and <em>in vivo</em> studies of SS and DED mouse models. A significant response occurs at a functional level with improved tear production and saliva flow rate and at a cellular level with reduced lymphocyte infiltration, improved corneal structural integrity, decreased epithelial cell apoptosis, and dampening of the inflammatory cytokine response. The proposed mechanisms of EV action include PD-L1, PRDM, NLRP-3, and Nf-kb pathways, and an increase in M2 macrophage phenotype. Current use of exosomes in DED is limited due to their cumbersome isolation techniqus. Further research on human subjects is needed, in addition to optimizing exosome isolation and delivery methods.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 499-515"},"PeriodicalIF":5.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alessandro Feo , Elisa Stradiotto , Andrea Govetto , Paolo Forte , Giacomo Boscia , Massimo Nicolò , Jennifer Cattaneo , Chiara M. Eandi , Martina Angi , Prithvi Ramtohul , Mario R. Romano
{"title":"Bacillary layer detachment: Updates on its clinical and prognostic significance in retinal disease","authors":"Alessandro Feo , Elisa Stradiotto , Andrea Govetto , Paolo Forte , Giacomo Boscia , Massimo Nicolò , Jennifer Cattaneo , Chiara M. Eandi , Martina Angi , Prithvi Ramtohul , Mario R. Romano","doi":"10.1016/j.survophthal.2025.01.005","DOIUrl":"10.1016/j.survophthal.2025.01.005","url":null,"abstract":"<div><div>Bacillary layer detachment (BALAD) refers to the distinctive splitting at the level of the photoreceptor inner segment myoid and accumulation of intraretinal fluid, as seen on optical coherence tomography (OCT). BALAD is an increasingly recognized OCT biomarker of numerous heterogeneous chorioretinal diseases, including posterior uveitis, age-related macular degeneration and macular neovascularization, neoplastic and paraneoplastic retinal disorders, rhegmatogenous retinal detachment, blunt ocular trauma, and miscellaneous conditions. The recognition of BALAD is clinically relevant because, based on the specific etiology, BALAD may require simple observation, ocular or systemic medical treatment, or even surgical intervention, with subsequent different prognosis. We discuss and summarize the clinical and prognostic significance of BALAD in the different chorioretinal disorders in which it has been described.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 401-411"},"PeriodicalIF":5.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lindsey B. De Lott , Chelsea Kaplan , Steven Harte , Daniel J. Clauw , Anat Galor , Jelle Vehof , Roni M. Shtein
{"title":"Nociplastic pain among individuals with chronic ocular surface pain: One cause for “pain without stain”?","authors":"Lindsey B. De Lott , Chelsea Kaplan , Steven Harte , Daniel J. Clauw , Anat Galor , Jelle Vehof , Roni M. Shtein","doi":"10.1016/j.survophthal.2025.01.004","DOIUrl":"10.1016/j.survophthal.2025.01.004","url":null,"abstract":"<div><div>Chronic ocular surface pain (COSP) refers to interrelated symptoms such as burning, aching, and irritation and can occur as an isolated condition or comorbid with numerous ocular disorders, including dry eye syndrome Treatments for COSP are largely aimed at the ocular surface and modulating pain arising from damaged corneal nerves; however, the average impact of these treatments on COSP are low to absent. A potential explanation for this is that, in a subset of patients with COSP, individuals have amplified and/or dysregulated neural signaling and sensory processing within the central nervous system (CNS). As in other chronic pain conditions, this might be the pathogenic mechanism primarily responsible for maintaining pain - a phenomenon now referred to as nociplastic pain. The key clinical features of nociplastic pain include symptoms out of proportion to signs, regional or widespread pain, the presence of other chronic pain conditions, and non-pain CNS mediated symptoms (e.g., sleep disorders). We provide an overview for eye care clinicians of nociplastic pain and delineate the emerging evidence for the presence of nociplastic pain among some individuals with COSP. We highlight gaps in our current understanding of nociplastic pain in COSP and provide clinicians with specific tools that may aid in the assessment and management of nociplastic pain.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 536-543"},"PeriodicalIF":5.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ting-Han Lin (MD) , Hung-Yi Lin (PhD) , Po-Chen Tseng (MD)
{"title":"Enhancing anti-vascular endothelial growth factor with photodynamic therapy for polypoidal choroidal vasculopathy: A meta-analysis","authors":"Ting-Han Lin (MD) , Hung-Yi Lin (PhD) , Po-Chen Tseng (MD)","doi":"10.1016/j.survophthal.2024.12.006","DOIUrl":"10.1016/j.survophthal.2024.12.006","url":null,"abstract":"<div><div>Anti-vascular endothelial growth factor (anti-VEGF) agents administered as either monotherapy or combination with verteporfin photodynamic therapy (PDT) are the 2 dominant treatment for polypoidal choroidal vasculopathy (PCV); however, controversies remain due to small sample sizes and inconsistency in prognosis from randomized controlled trials (RCTs). In accordance with the PRISMA statement, we investigated the efficacy of PDT plus anti-VEGF combination with anti-VEGF monotherapy. This study was accepted by the International Prospective Register of Systematic Reviews (CRD42023471362). Studies published up to July, 2024, were retrieved from PubMed, Embase, and Cochrane databases. A total of 7 RCTs with 926 eyes were reviewed. In 6 trials, combination therapy showed significantly higher rate of complete polyp regression (risk ratio [RR]: 1.56, 95 % CI: 1.15–2.13, p = 0.005). In 5 trials, combination therapy also significantly reduced the number of anti-VEGF injections (SMD: –0.65, 95 % CI: –0.95 to –0.35, p < 0.0001). For best corrected visual acuity improvement, central retinal thickness reduction, and rate of ocular adverse events, the performance of the 2 modalities were comparable. We conclude that PDT plus anti-VEGF combination therapy constitutes a safe and effective modality and should be considered the first-line treatment for PCV.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 380-388"},"PeriodicalIF":5.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ngoc Van Anh Le MD , Ngoc Cong Nguyen MD , Ngamjit Kasetsuwan MD , Usanee Reinprayoon MD
{"title":"Penetrating keratoplasty versus deep anteriror lamellar keratoplasty for macular corneal dystrophy: A meta-analysis","authors":"Ngoc Van Anh Le MD , Ngoc Cong Nguyen MD , Ngamjit Kasetsuwan MD , Usanee Reinprayoon MD","doi":"10.1016/j.survophthal.2024.12.005","DOIUrl":"10.1016/j.survophthal.2024.12.005","url":null,"abstract":"<div><h3>Study design</h3><div>We assessed the efficacy of deep anterior lamellar keratoplasty (DALK) and penetrating (PK) for macular corneal dystrophy (MCD)</div><div>We searched on 4 databases for articles published up to the end of April, 2024. The study's outcome was postoperative visual acuity and other factors that may affect visual outcomes (e.g., spherical equivalent and postoperative complications). Meta-analysis was performed using random-effects or fixed-effect model according to the heterogeneity.</div><div>We included 6 studies (1 RCT and 5 retrospective studies) comparing DALK (139 eyes) and PK (507 eyes) for MCD. No significant differences were found between the 2 procedures in uncorrected visual acuity, best-corrected visual acuity, and spherical equivalent (p = 0.58, 0.11 and 0.2, respectively). The risk of graft rejection was significantly higher in the PK group than in the DALK group (RR = 0.33; P = 0.001); however, MCD recurrence results were considerably higher in the DALK group than in the PK group (RR = 2.69, p < 0.001). The risk ratio for complications and graft survival have no significant difference between the two interventions (p = 0.9 and 0.62, respectively). Among the studies reviewed, 5 had a moderate risk of bias, while the remaining had a high risk.</div><div>Our results showed that both PK and DALK have comparable outcomes of postoperative visual acuity, spherical equivalent, graft survival, and complication rate when treating MCD. Although the PK group had a higher rate of graft rejection, the DALK group had a higher recurrence rate.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 480-488"},"PeriodicalIF":5.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Servillo MD , Pierluigi Scandale MDs , Gloria Oldoni MD , Pinar Guran Begar MD , Francesco Bandello MD , Elisabetta Miserocchi MD , Maria Vittoria Cicinelli MD
{"title":"Inflammatory choroidal neovascularization: An evidence-based update","authors":"Andrea Servillo MD , Pierluigi Scandale MDs , Gloria Oldoni MD , Pinar Guran Begar MD , Francesco Bandello MD , Elisabetta Miserocchi MD , Maria Vittoria Cicinelli MD","doi":"10.1016/j.survophthal.2024.12.004","DOIUrl":"10.1016/j.survophthal.2024.12.004","url":null,"abstract":"<div><div>Inflammatory choroidal neovascularization (iCNV) significantly contributes to vision impairment and ranks as the third primary cause of CNV. Arising from both infectious and noninfectious uveitis, iCNV's pathogenesis involves Bruch membrane rupture, local inflammation, and choriocapillaris ischemia. The diagnosis of iCNV is challenging due to its symptomatic overlap with other uveitis-related conditions. We emphasize the importance of advanced multimodal imaging techniques, particularly optical coherence tomography (OCT) and OCT angiography (OCTA), for early detection and differentiation of iCNV from other types of CNV. Although anti-vascular endothelial growth factor agents have shown high efficacy in treatment, the integration of these treatments with anti-inflammatory therapies remains a critical area of active research. The diversity of uveitis presentations and the rarity of iCNV have resulted in a scarcity of randomized clinical trials, leading to reliance on fragmented data from case reports and series. We consolidate the most recent studies to provide a comprehensive, updated overview of the epidemiology, risk factors, pathogenesis, imaging techniques, and treatment modalities for iCNV, aiming to support clinical decision-making. The absence of standardized guidelines highlights the need for further research to establish best practices for managing iCNV effectively.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 451-466"},"PeriodicalIF":5.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anuwat Jiravarnsirikul , Akram Belghith , Jasmin Rezapour , Christopher Bowd , Sasan Moghimi , Jost B. Jonas , Mark Christopher , Massimo A. Fazio , Hongli Yang , Claude F. Burgoyne , Robert N. Weinreb , Linda M. Zangwill
{"title":"Evaluating glaucoma in myopic eyes: Challenges and opportunities","authors":"Anuwat Jiravarnsirikul , Akram Belghith , Jasmin Rezapour , Christopher Bowd , Sasan Moghimi , Jost B. Jonas , Mark Christopher , Massimo A. Fazio , Hongli Yang , Claude F. Burgoyne , Robert N. Weinreb , Linda M. Zangwill","doi":"10.1016/j.survophthal.2024.12.003","DOIUrl":"10.1016/j.survophthal.2024.12.003","url":null,"abstract":"<div><div>The increasing global prevalence of myopia presents a significant public health concern, and growing evidence has demonstrated that myopia is a major risk factor for the development of open-angle glaucoma. Therefore, timely detection and management of glaucoma in myopic patients are crucial; however, identifying the structural alterations of glaucoma in the optic nerve head (ONH) and retinal tissues of myopic eyes using standard diagnostic tools such as fundus photography, optical coherence tomography (OCT), and OCT angiography (OCTA) presents challenges. Additionally, myopia-related perimetric defects can be confounded with glaucoma-related defects. We comprehensively examine the challenges encountered in evaluating glaucoma in myopic eyes through various diagnostic tools, including fundus photography, OCT of the ONH, retinal nerve fiber layer, and macular ganglion cell layer, OCTA, and perimetry. We also explore potential opportunities to address these challenges, providing insights for clinicians to effectively manage myopic glaucoma patients in clinical practice.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 563-582"},"PeriodicalIF":5.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postoperative complications of intrascleral intraocular lens fixation: A systematic review and meta-analysis","authors":"Ken Nagino PhD , Takenori Inomata MD, PhD, MBA , Toshihiko Ohta MD, PhD , Jaemyoung Sung MD , Akie Midorikawa-Inomata RN, MPH, PhD , Atsuko Eguchi PhD , Gaku Ishida MD , Keiji Inagaki MD, PhD , Masahiro Yamaguchi MD, PhD , Satoru Nakatani MD, PhD , Kenta Fujio MD, PhD , Hiroyuki Kobayashi MD, PhD , Shintaro Nakao MD, PhD","doi":"10.1016/j.survophthal.2024.12.001","DOIUrl":"10.1016/j.survophthal.2024.12.001","url":null,"abstract":"<div><div>Our systematic review and meta-analysis elucidates the postoperative complication rates associated with 3 major surgical approaches, including the scleral tunnel, glued, and flanged techniques, for sutureless intrascleral intraocular lens (IOL) fixation. An online search was performed for articles published in PubMed and EMBASE between January 1, 1975, and January 7, 2023. Original studies reporting postoperative complications of sutureless intrascleral IOL fixation were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The initial search yielded 1854 articles, from which 1797 were excluded; 57 and 51 were included in the qualitative synthesis and meta-analysis, respectively. Based on the meta-analysis, the postoperative complication rates of cystoid macular edema (5.7 %), retinal detachment (3.5 %), vitreous hemorrhage (8.8 %), and hypotony (5.5 %) were highest with the scleral tunnel technique. The glued technique had the highest complication rate for corneal edema (14.2 %). The rates of temporarily elevated intraocular pressure (9.9 %), iris capture (5.4 %), haptic exposure (6.5 %), and IOL decentration (7.3 %) were the highest with the flanged technique. The flanged technique had a significantly shorter operative time (median, 17.1 min) compared with the scleral tunnel (42.7 min) and glued (56.5 min) techniques. Postoperative best-corrected visual acuity with the flanged technique was significantly better than that with the other techniques (<em>P</em> = 0.017). This meta-analysis identified high postoperative complication rates related to the impact of surgical manipulations with the scleral tunnel technique and IOL placement stability with the flanged technique. These findings enable surgeons to minimize postoperative complications in high-risk patients.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 489-498"},"PeriodicalIF":5.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmad Santina , Alessandro Feo , Elodie Bousquet , Swetha B. Velaga , Néda Abraham , Meira Fogel-Levin , Veronica Romero-Morales , Swathi Somisetty , Alice Wong , Anthony Lu , Muneeswar Nittala , Jay Chhablani , Shilo Voichanski , Adrian Au , SriniVas Sadda , David Sarraf
{"title":"Pentosan polysulfate sodium maculopathy: Final analysis of a prospective cohort, updated review, and association with inflammatory bowel disease","authors":"Ahmad Santina , Alessandro Feo , Elodie Bousquet , Swetha B. Velaga , Néda Abraham , Meira Fogel-Levin , Veronica Romero-Morales , Swathi Somisetty , Alice Wong , Anthony Lu , Muneeswar Nittala , Jay Chhablani , Shilo Voichanski , Adrian Au , SriniVas Sadda , David Sarraf","doi":"10.1016/j.survophthal.2024.12.002","DOIUrl":"10.1016/j.survophthal.2024.12.002","url":null,"abstract":"<div><div>Pentosan polysulfate sodium (PPS) maculopathy is a recently described condition of macular toxicity. We report the prevalence (15 %), the clinical characteristics, and the multimodal imaging (MMI) features of PPS maculopathy based on a final prospective analysis of a cohort of 154 subjects and highlight the association with inflammatory bowel disease (IBD). In addition, we summarize the most recent and relevant literature on PPS maculopathy. This study and other recent analyses provide solid evidence of the toxic effects of PPS on the retina and choroid and refute the concept that the maculopathy is an association of the underlying disease, interstitial cystitis. Moreover, this study and others raise a major concern that PPS may also be toxic to the bowel. Vigilant surveillance of patients receiving this potentially harmful drug is critical. We review the recommended screening guidelines, the pathophysiology and MMI spectrum of disease, the differential diagnosis including MMI clues to an accurate diagnosis, and the progression of retinopathy that can take place despite discontinuation of the drug, emphasizing the critical importance of early detection of toxicity.</div></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"70 3","pages":"Pages 583-592"},"PeriodicalIF":5.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}