Medical Hypothesis, Discovery, and Innovation in Ophthalmology最新文献

{"title":"Acute and sub-acute ocular manifestations in pediatric patients with COVID-19: A systematic review.","authors":"Sedigheh Madani","doi":"10.51329/mehdiophthal1440","DOIUrl":"10.51329/mehdiophthal1440","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic has been the most challenging health problem in the last 2 years. Post-COVID-19 multisystem inflammatory syndrome of children (MIS-C) is a severe post-COVID-19 complication in pediatric patients. Ocular manifestations may be the first presentation of MIS-C, wherein prompt treatment may improve outcomes. In this systematic review, we aimed to summarize the acute and sub-acute ocular manifestations in pediatric patients with laboratory-confirmed COVID-19.</p><p><strong>Methods: </strong>We included all online primary studies, with no language restriction and published between January 1, 2019 and November 18, 2020, reporting any acute or sub-acute ocular manifestations in children with laboratory-confirmed COVID-19. PubMed/MEDLINE was searched using the following MeSH and Emtree terms: \"eye,\" \"ophthalmologic,\" \"ocular,\" \"vision,\" \"conjunctivitis,\" \"severe acute respiratory syndrome coronavirus 2,\" \"SARS-CoV-2,\" \"corona,\" \"2019-nCoV,\" \"COVID19,\" and \"COVID.\" The eligibility and quality of the selected records were assessed by two independent reviewers as per the Cochrane Handbook for Systematic Review.</p><p><strong>Results: </strong>A total of 1,192 records were identified electronically. Seven papers were extracted from the reference lists of the eligible records. Thirty-six papers met the inclusion criteria and were categorized into two subgroups according to acute or sub-acute presentation of ocular manifestations. Among 463 pediatric patients with COVID-19, 72 (15.5%) had acute ocular manifestations. There was one patient with central retinal vein occlusion and another with photophobia and diplopia associated with meningoencephalitis. Among 895 pediatric patients with post-COVID-19 MIS-C, 469 (52.4%) had ocular manifestations, which only included non-purulent conjunctivitis.</p><p><strong>Conclusions: </strong>Ocular manifestations have been reported in less than one-fifth of pediatric patients with acute COVID-19. Furthermore, conjunctivitis was the only ocular manifestation reported in half of the patients with MIS-C, and it may be missed easily due to its non-purulent nature. During the COVID-19 pandemic, pediatricians and health workers must remain vigilant for early detection of signs of this potentially fatal post-COVID-19 inflammatory syndrome.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"11 1","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/30/e0/mehdiophth-11-011.PMC10445324.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10484886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common causes of visual impairment in the elderly.","authors":"Mashael Al-Namaeh","doi":"10.51329/mehdiophthal1438","DOIUrl":"10.51329/mehdiophthal1438","url":null,"abstract":"<p><strong>Background: </strong>Aging is not a disease; rather, it is a process. As people age, visual impairment (VI) becomes more common. In 2010, the overall prevalence rate of vision impairment in all races was 25.66% in individuals aged ≥ 80 years, according to the estimate of the National Eye Institute at the National Institutes of Health. This review aimed to address the common causes of VI in the elderly.</p><p><strong>Methods: </strong>In this narrative review, an electronic search of the PubMed/MEDLINE database was conducted using \"visual impairment\" and \"elderly\" for the period between January 2010 and April 2021, to include randomized clinical trials and observational studies concerning VI in the elderly. The selected time period was chosen to provide an updated review.</p><p><strong>Results: </strong>The search yielded 2955 articles published over the period of more than 11 years. The relevant randomized clinical trials or observational studies were included and reviewed. Cataracts, refractive errors, open-angle glaucoma, age-related macular degeneration, and diabetic retinopathy were the most common age-related ocular disorders leading to VI if untreated in the elderly. The loss of visual acuity can adversely affect quality of life in the elderly. Difficulty with activities of daily living related to VI can lead to social isolation, depression, and anxiety. Loss of vision in the elderly is linked to an increased risk of falls, hip fracture, depression, and poor quality of life.</p><p><strong>Conclusions: </strong>The most common causes of VI in the elderly are cataracts and refractive errors. VI in most ocular diseases is more prevalent in women than in men due to longer lifespan. The overall prevalence of the main causes of VI in the elderly is expected to increase; therefore, health policymakers should consider this when planning for the health-enhancement program of the population.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"10 4","pages":"191-200"},"PeriodicalIF":0.0,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/aa/mehdiophth-10-191.PMC10460237.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10114184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial.","authors":"Ahmed Adel Abdelmonem,&nbsp;Ahmed Awadein,&nbsp;Mahmoud Mohamed M Genidy,&nbsp;Ahmed Shawkat Abdelhalim,&nbsp;Sahar Torky A Abdelaziz","doi":"10.51329/mehdiophthal1458","DOIUrl":"https://doi.org/10.51329/mehdiophthal1458","url":null,"abstract":"<p><strong>Background: </strong>Adjustable sutures increase the success rate of strabismus surgery. However, the optimal timing of postoperative suture adjustment remains controversial. This trial was aimed at comparing the surgical outcomes and pain scores of early or 2 - 4 h and delayed or 24 h postoperative suture adjustment in adult patients undergoing strabismus surgery.</p><p><strong>Methods: </strong>An open-label, prospective, randomized, comparative interventional study was performed in consecutive adult patients scheduled for eye muscle surgery. Patients were randomized into two groups: the early group, with suture adjustment 2 - 4 h postoperatively, and the delayed group, with suture adjustment 24 h postoperatively. Subjective pain scores during the adjustment were also analyzed. The angles of misalignment at 1 and 3 months and the success rate at 3 months postoperatively were compared.</p><p><strong>Results: </strong>Forty-five (90%) patients completed the follow-up, including 23 (92%) in the early adjustment group and 22 (88%) in the delayed adjustment group, with a mean (standard deviation) age of 25.6 (9.5) years and a male-to-female ratio of 46.7:53.3. Thirty patients (66.7%) had exotropia, and 15 (33.3%) patients had esotropia. Both groups had comparable baseline characteristics (all P > 0.05). The mean pain scores during adjustment did not differ significantly between groups (<i>P</i> > 0.05). The postoperative angles of alignment were comparable between the groups before suture adjustment and at the 1- and 3-month follow-ups (all <i>P</i> > 0.05). The success rate in the early adjustment group was slightly higher (87.0% versus 63.6%), but the difference was not statistically significant (<i>P</i> > 0.05). The success rate was comparable between the groups in patients with esotropia or exotropia (both <i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>Although the early adjustment group had a slightly higher success rate, the difference was not significant. Both groups had comparable subjective pain scores during adjustment, final motor alignment, or success rate. Future clinical trials should be performed different time intervals for postoperative suture adjustment, and subjective and objective outcomes, such as diplopia and stereopsis, should be compared between patients with a first strabismus surgery and those who underwent reoperation. This could better resolve the persistent controversy related to the optimal time for suture adjustment.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"11 4","pages":"144-150"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/b9/mehdiophth-11-144.PMC10460247.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronavirus disease pandemic and dry eye disease: A methodology concern on the causal relationship.","authors":"Mashael Al-Namaeh","doi":"10.51329/mehdiophthal1444","DOIUrl":"https://doi.org/10.51329/mehdiophthal1444","url":null,"abstract":"Editorial","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"11 1","pages":"42-43"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/24/mehdiophth-11-042.PMC10445325.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10484884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of vision screening program conducted by preschool teachers: An interventional study.","authors":"Uddin Mezbah,&nbsp;Rokiah Omar,&nbsp;Zaleha Md Isa,&nbsp;Victor Feizal Knight","doi":"10.51329/mehdiophthal1439","DOIUrl":"https://doi.org/10.51329/mehdiophthal1439","url":null,"abstract":"<p><strong>Background: </strong>Clear vision is crucial for effective learning among preschool children. Hence, early detection of vision impairment and prompt treatment are required to improve prognosis. Currently, limited information is available, and no program exists to screen for vision impairment among preschoolers in Bangladesh. This study aimed to validate the KieVision™ Preschool Vision Screening Kit, translated into the Bengali language, to improve vision impairment detection among preschool children.</p><p><strong>Methods: </strong>In this prospective case-control study, 60 preschool teachers from Chittagong were randomly selected. The study group was trained to conduct vision screening among preschool children using the translated kit, whereas the control group was trained using the Chittagong Eye Infirmary and Training Complex (CEITC) School Teachers' Training Module. Fifteen preschool children aged 4-6 years were screened by each preschool teacher and again by the optometrist.</p><p><strong>Results: </strong>Sixty preschool teachers screened 900 children. The results showed a higher validity of vision screening findings by the preschool teachers in the study group (sensitivity, 68.00%; specificity, 92.75%) than in the control group (sensitivity 47.37%, specificity 70.39%). The level of agreement between the preschool teachers and optometrists was high for all tests (first-order agreement coefficient [AC1] ≥ 0.80 in the study group). The sensitivity and specificity of the visual acuity test for the study group were 59.65% and 94.15%, respectively, while in the control group it was 13.33% and 62.54%, respectively. A similar trend was noted in the general observation component and Hirschberg's test.</p><p><strong>Conclusions: </strong>The Bengali Language KieVision™ Preschool Vision Screening Kit can be used effectively by preschool teachers in vision screening programs to improve the identification of vision impairment among preschool children in Bangladesh.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"11 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/45/mehdiophth-11-001.PMC10445321.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10484887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factor assessment of digital eye strain during the COVID-19 pandemic: a cross-sectional survey.","authors":"Nancy M Lotfy,&nbsp;Heba M Shafik,&nbsp;Mona Nassief","doi":"10.51329/mehdiophthal1455","DOIUrl":"https://doi.org/10.51329/mehdiophthal1455","url":null,"abstract":"<p><strong>Background: </strong>Shifting to online learning during the coronavirus pandemic has increased the number of individuals symptomatic of digital eye strain (DES). This study aimed to determine the frequency and potential risk factors of DES among university staff members and students in this pandemic era.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted during the pandemic, in May and June 2020. The online questionnaire was designed to collect data on DES-related ocular and extraocular manifestations. The survey was sent via social media to the previous year's students and staff within the Faculty of Medicine, Tanta University, Tanta, Egypt. The responses were downloaded and analyzed.</p><p><strong>Results: </strong>Of the 412 participants completing the questionnaire, 34 (8.3%) were university staff members with a mean (standard deviation [SD]) age of 36.7 (6.6) years, and 378 (91.7%) were university students with a mean (SD) age of 20.8 (1.8) years. Participants with DES symptoms numbered 294 (71.4%) before the lockdown, increasing to 366 (88.8%) during the last month, with 84 developing new-onset DES. Most participants reported ocular symptoms associated with DES. After the lockdown, both students and staff had a significant prolongation of nighttime digital screen use and TV watching, an increase in the 4-item Patient Health Questionnaire (PHQ-4) severity scale scores, and anxiety and depression, with a reduced duration of daytime reading (all P < 0.05). Students had a significant prolongation of daytime digital screen use and TV watching and an increase in the frequency of eye lubricant use and mean Perceived Stress Scale (PSS)-4 scores (all <i>P</i> < 0.05). Multiple logistic regression analysis revealed that studenthood and increased nighttime screen use were independent risk factors for DES by odds ratios (95% confidence intervals) of 10.60 (2.12 - 53.00) and 3.99 (1.71 - 9.34), respectively (both <i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>Lockdown and closure of the university, with a shift to online learning, increased the exposure of staff and students to digital screens and the number of individuals with DES. Studenthood and prolonged nighttime digital screen use were independent risk factors for DES. Further studies investigating the prevalence and risk factors of DES, comparing similar data during and after the pandemic, may reveal other aspects of DES caused by virtual reality-based training.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"11 3","pages":"119-128"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/07/mehdiophth-11-119.PMC10445314.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal endothelium, retinal nerve fiber layer, ganglion cell complex, and perimetry measurements in normal eyes and those with primary open-angle glaucoma.","authors":"Elshimaa A Mateen Mossa,&nbsp;Khulood Muhammad Sayed,&nbsp;Amr Mounir,&nbsp;Hatem Ammar","doi":"10.51329/mehdiophthal1450","DOIUrl":"https://doi.org/10.51329/mehdiophthal1450","url":null,"abstract":"<p><strong>Background: </strong>Corneal endothelial cell (CEC) loss in glaucoma can be attributed to the direct compressive effect of elevated intraocular pressure. Herein, we aimed to evaluate specular microscopic changes in CEC count and morphology in correlation to retinal nerve fiber layer (RNFL) changes detected by spectral-domain optical coherence tomography (SD-OCT) in early and advanced primary open-angle glaucoma (POAG).</p><p><strong>Methods: </strong>This descriptive-analytical study involved patients with medically controlled POAG versus non-glaucomatous patients of the same age group. Specular microscopy, visual field testing, and SD-OCT of the RNFL and macular ganglion cell complex (GCC) were performed. Eyes with POAG were further subcategorized into early and advanced stages.</p><p><strong>Results: </strong>The study included 130 eyes of 130 participants; 70 were eyes with POAG (40 eyes with early-stage POAG, 30 eyes with advanced-stage POAG), and 60 were healthy eyes. The groups were comparable regarding mean age and sex. No significant difference was found in corneal parameters between healthy eyes, eyes with early POAG, and eyes with advanced POAG (all <i>P</i> > 0.05). In eyes with early-stage POAG, a significant negative correlation was found between the coefficient of variation (CV) and superior RNFL thickness (r = - 0.5; <i>P</i> = 0.018), and between the percentage of hexagonal cells (hexagonality) and vertical cup-to-disc ratio (r = - 0.43; P = 0.035). A significant positive correlation was found between hexagonality and superior as well as inferior RNFL thickness (r = + 0.53; <i>P</i> = 0.008 and r = + 0.50; <i>P</i> = 0.015, respectively). However, in the advanced glaucomatous eyes, no significant correlation was found between RNFL thickness and CEC parameters.</p><p><strong>Conclusions: </strong>\u0000 <b>CEC parameters were not affected in eyes with early or advanced POAG compared with healthy eyes, despite a significant thinning of RNFL and macular GCC. In eyes with early-stage POAG, a significant correlation was found between morphological characteristics of CECs, such as CV and hexagonality, with superior and inferior RNFL thickness in the optic nerve head on SD-OCT images. Future longitudinal studies with larger sample sizes are needed to verify our results.</b>\u0000 </p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"11 2","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/7c/mehdiophth-11-085.PMC10445305.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10484900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical coherence tomography angiography in intermediate uveitis-related cystoid macular edema.","authors":"Leila Alizadeh Ghavidel,&nbsp;Farideh Mousavi,&nbsp;Hesam Sadat Hashemi,&nbsp;Masood Bagheri","doi":"10.51329/mehdiophthal1441","DOIUrl":"https://doi.org/10.51329/mehdiophthal1441","url":null,"abstract":"<p><strong>Background: </strong>Cystoid macular edema (CME) is the leading cause of permanent visual impairment in patients with uveitis, particularly in patients with intermediate uveitis (IU). This study was aimed at comparing the changes in the macular microvasculature in patients with IU with uveitic non-responsive CME and without macular edema.</p><p><strong>Methods: </strong>In this case-control study, 55 eyes of patients with IU were assessed for macular microvascular structures, including vascular density, foveal avascular zone (FAZ) measurement, and vascular morphological changes, using spectral-domain optical coherence tomography angiography (OCT-A) with the AngioVue OCT-A system. We divided patients into the following two groups: the case group, including 30 eyes with IU-related non-responsive CME, and the control group, including 25 eyes with IU without macular edema.</p><p><strong>Results: </strong>Participants in the case and control groups had comparable age (P = 0.753) and sex (P = 0.124) distributions. Superficial capillary plexus vessel density in the case group was significantly decreased in the whole image (P = 0.027) and the parafoveal area (P = 0.001) compared to the control group. However, there were no statistically significant differences between the two groups in terms of foveal superficial vessel density, deep capillary plexus vessel density, FAZ area, FAZ perimeter, FAZ acircularity index, or foveal vessel density in a 300-µm-wide annulus around the FAZ (all P > 0.05). Vascular morphological changes, such as the capillary tuft, telangiectatic vessels, or micro-aneurism, were not different in the overview images of the OCT-A printout between the two groups.</p><p><strong>Conclusions: </strong>The mean superficial capillary plexus vessel density was lower in eyes with IU-related nonresponsive CME than in those without macular edema. We observed more cystoid spaces in SCP than in DCP. Microcystic changes in the inner retina and ischemia may be the underlying cause in eyes with nonresponsive CME. Future prospective longitudinal studies with healthy, matched controls are warranted to confirm our findings.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"11 1","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/cc/mehdiophth-11-019.PMC10445323.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10111412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbonic anhydrase inhibitors in the management of macular edema: A review of the literature.","authors":"Marianne L Shahsuvaryan","doi":"10.51329/mehdiophthal1443","DOIUrl":"https://doi.org/10.51329/mehdiophthal1443","url":null,"abstract":"<p><strong>Background: </strong>Macular edema (ME) is a vision-threatening condition that commonly develops as a consequence of ocular diseases, including age-related macular degeneration, retinal vaso-occlusion of the central retinal vein and its branches, diabetic retinopathy, central serous chorioretinopathy, uveitis, retinitis pigmentosa, pseudophakia, ocular trauma, and drug toxicity. The treatment of ME remains challenging, although steroids and vascular endothelial growth factor inhibitors are available. Cost-effective therapy using a noninvasive administration route is required. This study aimed at reviewing the role of carbonic anhydrase inhibitors (CAIs) in the management of ME.</p><p><strong>Methods: </strong>A literature search was conducted using PubMed/MEDLINE and Google Scholar for studies from January 2000 to March 2022. The following keywords were used in various combinations: \"macular edema\", \"carbonic anhydrase\", \"carbonic anhydrase inhibitors\", \"acetazolamide\", \"dorzolamide\", and \"brinzolamide\".</p><p><strong>Results: </strong>Articles with high or medium clinical relevance were selected for this review. We found that multiple studies have demonstrated the relevance and efficacy rates of CAIs in the management of ME. Most published studies focused on acetazolamide and dorzolamide, with nearly all studies reporting therapeutic responses.</p><p><strong>Conclusions: </strong>ME is the leading cause of vision loss and requires noninvasive and cost-effective pharmacotherapy. With progress in the understanding of ME, particularly the role of carbonic anhydrase as a key driver, CAIs are the focus of research. Further optimization of the choice of CAIs and retinal bioavailability, potentially with nanoparticle formulations, is required to enable the effective management of ME. Further research is warranted to address the therapeutic effects of CAIs in different formulations.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"11 1","pages":"34-41"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/8a/mehdiophth-11-034.PMC10445326.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10484883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of eye drops from umbilical cord blood platelet lysate to treat resistant corneal ulcer.","authors":"Rania Kamel Farag,&nbsp;Mervat Dawood,&nbsp;Maher Elesawi","doi":"10.51329/mehdiophthal1463","DOIUrl":"https://doi.org/10.51329/mehdiophthal1463","url":null,"abstract":"<p><strong>Background: </strong>Umbilical cord blood (UCB) is a novel treatment of resistant corneal ulcers owing to the unique anti-inflammatory molecules and growth factors it contains. Platelet lysates are a potential future alternative. The aim of the present study was to assess the role of human UCB platelet lysate in treating resistant corneal ulcers.</p><p><strong>Methods: </strong>This was prospective, non-comparative, interventional case series involving 40 eyes of patients aged 6 - 65 years with persistent corneal ulcers from the Mansoura Ophthalmic Center and Mansoura Research Center for Cord Stem Cells. Patients were classified according to the cause of persistent corneal ulcer into four groups: group I, including 14 eyes with dry eye disease; group II, including six eyes post-keratoplasty; group III, including four eyes with corneal chemical burn; and group IV, including 16 eyes with persistent corneal ulcer from other causes. All participants underwent detailed ophthalmic examinations, and baseline and final best-corrected distance visual acuity (BCDVA) were recorded. Eye drops were prepared from UCB platelet lysate and administered to all patients along with detailed meticulous instructions for the method of use. Clinical progression of wound healing was continuously observed. The treatment response was identified as complete healing, improvement, or treatment failure.</p><p><strong>Results: </strong>BCDVA improved significantly in all studied groups (all <i>P</i> < 0.05). In group I, complete healing, improvement, and treatment failure occurred in 71%, 29%, and 0% of cases. In group II, complete healing, improvement, and treatment failure occurred in 67%, 33%, and 0% of cases. In group III, complete healing, improvement, and treatment failure occurred in 50%, 50%, and 0% of cases. In group IV, complete healing, improvement, and treatment failure occurred in 63%, 12%, and 25% of cases. No adverse events associated with the treatment were observed or subjectively self-reports in the study period.</p><p><strong>Conclusions: </strong>Eye drops from UCB platelet lysate were a novel therapeutic blood component with unique growth factors and anti-inflammatory compounds that could be an effective and safe treatment option in managing persistent corneal ulcers of different causes. A future randomized clinical trial with a large sample size and a longer follow-up is required to confirm these preliminary outcomes.</p>","PeriodicalId":36524,"journal":{"name":"Medical Hypothesis, Discovery, and Innovation in Ophthalmology","volume":"11 4","pages":"189-202"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/ef/mehdiophth-11-189.PMC10460244.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}