{"title":"A major review on punctal stenosis: Part II: Updated therapeutic interventions, complications, and outcomes","authors":"","doi":"10.1016/j.survophthal.2024.05.007","DOIUrl":"10.1016/j.survophthal.2024.05.007","url":null,"abstract":"<div><p><span><span><span>We continue our review of on punctal stenosis by providing a detailed discussion of management modalities, their complications, and outcomes. There is a significant change in the understanding of punctal and peripunctal anatomy, puncto-canalicular junction, and the lacrimal pump mechanisms. While the snip punctoplasty procedures are still practiced, there is an increasing trend toward nonincisional procedures. The nonincisional procedures in select cases appear to be equally effective as the incisional ones. Although simple to use, </span>punctal plugs never became the mainstay of treatment because of design issues and the inability to address the coexisting canalicular stenosis. Placing stents only in the lower punctum in cases of upper and lower punctal stenosis should be discouraged, and management needs to address punctal stenosis and not which punctum is involved. Several types of stents are used in the management of punctal stenosis, mostly based on surgeon’s preference. The benefits of adjuvant </span>mitomycin C are uncertain. In view of literature on how stent biofilms can themselves cause </span>chronic inflammation<span>, placing them for prolonged periods should be reviewed and debated. Enhanced understanding of the molecular pathogenesis of punctal stenosis and addressing the current controversies in management would help standardize the therapeutic interventions available in the lacrimal armamentarium.</span></p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138684","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":"Optical coherence tomography angiography measurements in systemic lupus erythematosus: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.survophthal.2024.04.007","DOIUrl":"10.1016/j.survophthal.2024.04.007","url":null,"abstract":"<div><p>Systemic lupus erythematosus<span> (SLE) is an autoimmune disease affecting various organs. Ocular involvement, particularly retinopathy<span><span>, is common, emphasizing the significance of early detection. Optical coherence tomography angiography (OCTA), a non-invasive </span>imaging technique<span><span><span>, reveals microvascular changes, aiding SLE diagnosis and monitoring. This study evaluates OCTA's effectiveness in detecting SLE-related retinal alterations. A systemic search was undertaken across PubMed, Embase, and Scopus databases to identify studies presenting OCTA measurements in SLE patients compared to healthy controls. The meta-analysis, employing either fixed-effects or random-effects models based on heterogeneity levels, was conducted. Additionally, subgroup and sensitivity analyses, meta-regression, and quality assessments were carried out. Thirteen studies of 565 eyes in the SLE group and 560 eyes in the control group were included. The meta-analyses revealed that SLE patients had a significantly lower retinal vessel density in the superficial and deep capillary plexus layers, choriocapillaris flow area, and foveal avascular zone (FAZ) circularity index compared to healthy controls, but that there were no significant differences in the FAZ area and perimeter. These findings highlight how OCTA can provide a noninvasive assessment of SLE effects on the retinal </span>microvasculature, potentially presenting a reliable biomarker for more precise detection of SLE and </span>disease activity monitoring.</span></span></span></p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923193","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":"Future directions of generative artificial intelligence in ophthalmology and vision science","authors":"","doi":"10.1016/j.survophthal.2024.06.003","DOIUrl":"10.1016/j.survophthal.2024.06.003","url":null,"abstract":"","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331728","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":"Neurotrophic keratopathy: General features and new therapies.","authors":"","doi":"10.1016/j.survophthal.2024.04.004","DOIUrl":"10.1016/j.survophthal.2024.04.004","url":null,"abstract":"<div><p>Neurotrophic keratopathy is an uncommon degenerative corneal disorder characterized by compromised corneal sensory innervation resulting in the formation of epithelial defects and nonhealing corneal ulcers. Various treatment modalities are available to stabilize disease progression, improve patient well-being, and prevent vision loss. For eligible patients, medical and surgical reinnervation have emerged as pioneering therapies, holding promise for better management. We present a comprehensive review of the disorder, providing an update relevant to ophthalmologists on pathogenesis, diagnosis, treatment options, and novel therapies targeting pathophysiological pathways.</p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0039625724000420/pdfft?md5=67c1b39012b1561e1d4f2b0b4980d0ae&pid=1-s2.0-S0039625724000420-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866601","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}
{"title":"The potential impact of a vegetarian diet on glaucoma","authors":"","doi":"10.1016/j.survophthal.2024.05.001","DOIUrl":"10.1016/j.survophthal.2024.05.001","url":null,"abstract":"<div><p>Treatment of primary open-angle glaucoma has centered on the lowering of intraocular pressure that damages the optic nerve; however, this strategy is not uniformly successful, especially in normal tension glaucoma, and there is interest in antioxidant, anti-inflammatory, and other neuroprotective strategies. Vegetarian diets are known to be rich in antioxidant and anti-inflammatory components and have a number of established health benefits. Thus, it would be reasonable to assume that vegetarian diets would be beneficial in glaucoma, but this approach has not been well studied. We examine the possible role of vegetarian diets and their components in the incidence and progression of glaucoma.</p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0039625724000481/pdfft?md5=10a4994592af1849720933ee63c5351b&pid=1-s2.0-S0039625724000481-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071863","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}
{"title":"Scoping review of nonsurgical treatment options for macular holes","authors":"","doi":"10.1016/j.survophthal.2024.04.005","DOIUrl":"10.1016/j.survophthal.2024.04.005","url":null,"abstract":"<div><p>Macular holes<span><span> (MH) are full-thickness retinal defects affecting central vision. While vitrectomy with </span>inner limiting membrane<span><span> (ILM) peel is the conventional MH treatment, non-surgical alternatives are gaining interest to mitigate surgical risks. This study conducted a comprehensive literature review and analysis of nonsurgical MH management. A systematic literature search was conducted on PubMed, Embase, Scopus, and the Cochrane Library from January 1, 1973, to September 13, 2023. Treatments included laser therapy, </span>carbonic anhydrase inhibitors<span><span> (CAIs), nonsteroidal antiinflammatory drugs (NSAIDs), steroids (topical, subtenons, peribulbar, intravitreal), intravitreal gas, anti-vascular endothelial growth factors and </span>ocriplasmin<span><span> injections. Data extraction covered study details, patient characteristics<span>, MH features, treatment outcomes, and recurrence rates. The initial search yielded 3352 articles, refined to 83 articles that met inclusion criteria following screening. Overall reported anatomical closure rates were 36% with laser photocoagulation, 37% with intravitreal </span></span>ocriplasmin<span>, 55% with intravitreal gas. Closures were more frequently observed with topical NSAIDs (79%), steroids (84%) and CAIs (73%). Closures were more often observed in patients with smaller MH and in the presence of cystic macular oedema. Although non-surgical MH management approaches show potential for conservative therapy, evidence is limited to support routine use. Stage 1 and traumatic MH may benefit from a short period of observation, but the gold standard approach for full-thickness MH remains to be vitrectomy with ILM peel.</span></span></span></span></span></p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795068","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":"Lupus review is misleading about risk of hydroxychloroquine retinal toxicity","authors":"","doi":"10.1016/j.survophthal.2024.07.007","DOIUrl":"10.1016/j.survophthal.2024.07.007","url":null,"abstract":"","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767506","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":"Generative artificial intelligence in ophthalmology: Correspondence","authors":"","doi":"10.1016/j.survophthal.2024.06.002","DOIUrl":"10.1016/j.survophthal.2024.06.002","url":null,"abstract":"","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427682","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":"Biomechanical considerations for optimising subretinal injections","authors":"","doi":"10.1016/j.survophthal.2024.05.004","DOIUrl":"10.1016/j.survophthal.2024.05.004","url":null,"abstract":"<div><p>Subretinal injection is the preferred delivery technique for various novel ocular therapies and is widely used because of its precision and efficient delivery of gene and cell therapies; however, choosing an injection point and defining delivery parameters to target a specified retinal location and area is an inexact science. We provide an overview of the key factors that play important roles during subretinal injections to refine the technique, enhance patient outcomes, and minimise risks. We describe the role of anatomical and physical variables that affect subretinal bleb propagation and shape and their impact on retinal integrity. We highlight the risks associated with subretinal injections and consider strategies to mitigate reflux and retinal trauma. Finally, we explore the emerging field of robotic assistance in improving intraocular manouvrability and precision to facilitate the injection procedure.</p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0039625724000535/pdfft?md5=5cac6d4d6d97ada1eb0e53bb4743d819&pid=1-s2.0-S0039625724000535-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141133064","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}
{"title":"Diabetic retinopathy screening through artificial intelligence algorithms: A systematic review","authors":"","doi":"10.1016/j.survophthal.2024.05.008","DOIUrl":"10.1016/j.survophthal.2024.05.008","url":null,"abstract":"<div><p>Diabetic retinopathy (DR) poses a significant challenge in diabetes management, with its progression often asymptomatic until advanced stages. This underscores the urgent need for cost-effective and reliable screening methods. Consequently, the integration of artificial intelligence (AI) tools presents a promising avenue to address this need effectively. We provide an overview of the current state of the art results and techniques in DR screening using AI, while also identifying gaps in research for future exploration. By synthesizing existing database and pinpointing areas requiring further investigation, this paper seeks to guide the direction of future research in the field of automatic diabetic retinopathy screening. There has been a continuous rise in the number of articles detailing deep learning (DL) methods designed for the automatic screening of diabetic retinopathy especially by the year 2021. Researchers utilized various databases, with a primary focus on the IDRiD dataset. This dataset consists of color fundus images captured at an ophthalmological clinic situated in India. It comprises 516 images that depict various stages of DR and diabetic macular edema. Each of the chosen papers concentrates on various DR signs. Nevertheless, a significant portion primarily focused on detecting exudates, which remains insufficient to assess the overall presence of this disease. Various AI methods have been employed to identify DR signs. Among the chosen papers, 4.7 % utilized detection methods, 46.5 % employed classification techniques, 41.9 % relied on segmentation, and 7 % opted for a combination of classification and segmentation. Metrics calculated from 80 % of the articles employing preprocessing techniques demonstrated the significant benefits of this approach in enhancing results quality. In addition, multiple DL techniques, starting by classification, detection then segmentation. Researchers used mostly YOLO for detection, ViT for classification, and U-Net for segmentation. Another perspective on the evolving landscape of AI models for diabetic retinopathy screening lies in the increasing adoption of Convolutional Neural Networks for classification tasks and U-Net architectures for segmentation purposes; however, there is a growing realization within the research community that these techniques, while powerful individually, can be even more effective when integrated. This integration holds promise for not only diagnosing DR, but also accurately classifying its different stages, thereby enabling more tailored treatment strategies. Despite this potential, the development of AI models for DR screening is fraught with challenges. Chief among these is the difficulty in obtaining the high-quality, labeled data necessary for training models to perform effectively. This scarcity of data poses significant barriers to achieving robust performance and can hinder progress in developing accurate screening systems. Moreover, managing the complex","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141404148","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}