Survey of ophthalmology最新文献

{"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":"69 5","pages":"Pages 677-696"},"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":"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":"69 5","pages":"Page 848"},"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":"69 5","pages":"Pages 722-732"},"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":"Lupus review is misleading about risk of hydroxychloroquine retinal toxicity","authors":"Michael F. Marmor","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":"69 5","pages":"Page 847"},"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":"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":"&lt;div&gt;&lt;p&gt;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":"69 5","pages":"Pages 707-721"},"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}

{"title":"The incidence of severe complications in acanthamoeba keratitis: Qualitative and quantitative systematic assessment","authors":"","doi":"10.1016/j.survophthal.2024.06.001","DOIUrl":"10.1016/j.survophthal.2024.06.001","url":null,"abstract":"<div><p><span><span>Acanthamoeba keratitis<span> (AK) is a rare, sight-threating corneal infection. The disease is challenging to diagnose and treat, and the </span></span>amoeba<span><span> can rapidly encyst, persisting in the tissue and causing recurrences. Medical therapy is conventionally considered the first line treatment, but advanced cases could require more invasive treatments like a “chaud” corneal transplant<span>. We review the incidence of severe complications in patients affected by AK. Of 439 reports screened, 158 met our inclusion criteria. Incidence of severe complications was low, with 2.21 % patients developing perforation, 1 % requiring evisceration/enucleation and less than 1 % developing endophthalmitis. Corneal transplantation was required in 16.68 % of the cases. According to our results, and considering the reported incidences of these complications in other infectious </span></span>keratitis<span>, AK patients have an overall low risk of developing perforation, endophthalmitis, and enucleation/evisceration. Nevertheless, data available in the literature remain poor, and further </span></span></span>randomized control trials are needed to confirm our findings.</p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"69 5","pages":"Pages 769-778"},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141400707","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":"The role of topical insulin in ocular surface restoration: A review","authors":"","doi":"10.1016/j.survophthal.2024.04.003","DOIUrl":"10.1016/j.survophthal.2024.04.003","url":null,"abstract":"<div><p><span><span>Corneal epithelial defects<span> are one of the most common ocular disorders. Restoring corneal integrity is crucial to reduce pain and regain function, but in cases of neurotrophic or desensitized corneas, healing can be significantly delayed. Treating neurotrophic corneas is challenging for ophthalmologists, and surgical intervention is often indicated to manage refractory cases that are unresponsive to medical therapy. Over the last decade, as more expensive therapeutics reach the market, topical insulin has returned to the forefront as an affordable option to improve </span></span>corneal wound healing. There is still a paucity of data on the use and the efficacy of topical insulin, with no consensus regarding its indications, preparation, or posology. Here we review the literature on topical insulin for corneal and </span>ocular surface pathologies, with a focus on the current evidence, its mechanisms of action, and its safety profile. Additionally, we share our experience in the field and provide a potential framework for future research.</p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"69 5","pages":"Pages 805-817"},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763983","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":"Leveraging neural plasticity for the treatment of amblyopia","authors":"","doi":"10.1016/j.survophthal.2024.04.006","DOIUrl":"10.1016/j.survophthal.2024.04.006","url":null,"abstract":"<div><p><span>Amblyopia is a form of visual cortical impairment that arises from abnormal visual experience early in life. Most often, amblyopia is a unilateral visual impairment that can develop as a result of strabismus, </span>anisometropia, or a combination of these conditions that result in discordant binocular experience. Characterized by reduced visual acuity and impaired binocular function, amblyopia places a substantial burden on the developing child. Although frontline treatment with glasses and patching can improve visual acuity, residual amblyopia remains for most children. Newer binocular-based therapies can elicit rapid recovery of visual acuity and may also improve stereoacuity in some children. Nevertheless, for both treatment modalities full recovery is elusive, recurrence of amblyopia is common, and improvements are negligible when treatment is administered at older ages. Insights derived from animal models about the factors that govern neural plasticity have been leveraged to develop innovative treatments for amblyopia. These novel therapies exhibit efficacy to promote recovery, and some are effective even at ages when conventional treatments fail to yield benefit. Approaches for enhancing visual system plasticity and promoting recovery from amblyopia include altering the balance between excitatory and inhibitory mechanisms, reversing the accumulation of proteins that inhibit plasticity, and harnessing the principles of metaplasticity. Although these therapies have exhibited promising results in animal models, their safety and ability to remediate amblyopia need to be evaluated in humans.</p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"69 5","pages":"Pages 818-832"},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065606","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":"Role of MYCN in retinoblastoma: A review of current literature","authors":"","doi":"10.1016/j.survophthal.2024.05.009","DOIUrl":"10.1016/j.survophthal.2024.05.009","url":null,"abstract":"<div><p><span>Chromosomal abnormalities<span><span><span> that involve the MYCN gene are rare; however, it is one of the most commonly mutated genes in </span>retinoblastoma (RB) after the RB1 gene. MYCN is amplified in approximately 1–9 % of all RB tumors. It plays a role in RB oncogenesis via many mechanisms, including synergism with RB1 deletion, positive feedback with MDM2, upregulation of cell cycle regulating genes, upregulation of </span>miRNA<span><span>, and upregulation of glucose metabolism. MYCN amplifications are not mutually exclusive and can occur even in the presence of RB1 </span>gene mutations. Clinically, RB1</span></span></span>^+/+MYCN^A<span><span> tumors present as sporadic, unilateral, advanced tumors in very young children and tend to follow an aggressive course. Magnetic resonance imaging features include peripheral tumor location, placoid configuration, retinal folding, tumor-associated </span>hemorrhage<span>, and anterior chamber enhancement. Genetic testing for MYCN</span></span>^A<span> is especially recommended in patients with unilateral RB where genetic blood testing and tumor tissue show a lack of RB1 mutation. MYCN-targeted therapies are evolving and hold promise for the future.</span></p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"69 5","pages":"Pages 697-706"},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141133384","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":"Refractive surgical approaches to keratoconus: A systematic review and network meta-analysis","authors":"","doi":"10.1016/j.survophthal.2024.04.008","DOIUrl":"10.1016/j.survophthal.2024.04.008","url":null,"abstract":"<div><p><span>Advancements in diagnostic methods and surgical techniques for keratoconus (KC) have increased non-invasive treatment options. Successful surgical planning for KC involves a combination of </span>clinical science<span><span>, empirical evidence, and surgical expertise. Assessment of disease progression is crucial, and halting the progression should be the focus if it is progressive. While surgeons used to rely on experience alone to decide the </span>surgical method<span><span><span>, comparing the network of primary factors, such as visual acuity, across studies can help them choose the most appropriate treatments for each patient and achieve optimal outcomes. Meticulous tabulation methods facilitate interpretation, highlighting the importance of selecting the correct surgical and rehabilitation approach based on each patient's condition and stage of the disease. We detail the outcomes of a comprehensive network meta-analysis comparing the effectiveness of various combined therapeutic refractive treatments for KC at identical stages of the disease, spanning 4 distinct follow-up intervals. Additionally, the comprehensive analysis suggests that for corneas with optimal </span>best corrected visual acuity (BCVA) preoperatively (classified as regular), combining phakic intraocular lenses with </span>intracorneal ring segments (ICRS) and corneal cross-linking (CXL) could offer the best therapeutic approach provided the disease stage does not exceed stage 3. For irregular corneas, although initial follow-ups show a significant difference in BCVA with surface ablation, longer-term follow-ups recommend combining surface ablation with ICRS and CXL, especially at higher stages.</span></span></p></div>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":"69 5","pages":"Pages 779-788"},"PeriodicalIF":5.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862987","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}