Expert Review of Ophthalmology最新文献

{"title":"What is on the horizon for dry age-related macular degeneration drug treatment?","authors":"Federico Rissotto, Riccardo Sacconi, Aurelio Apuzzo, Gloria Oldoni, Emanuele Fusi, Andrea Servillo, Francesco Bandello, Giuseppe Querques","doi":"10.1080/17469899.2023.2267179","DOIUrl":"https://doi.org/10.1080/17469899.2023.2267179","url":null,"abstract":"ABSTRACTIntroduction Age-related Macular Degeneration (AMD) is one of the leading causes of irreversible visual acuity reduction among the elderly population. Dry AMD, the most frequent AMD form, is characterized by photoreceptor loss, Retinal Pigmented Epithelium (RPE) dysfunction and retinal degeneration. Although in the last years several clinical trials have been carried out and many therapeutic molecules have been examined to treat dry AMD, currently its treatment remains unsatisfactory.Areas covered In this review we report and analyze the most important molecules and treatment that have been studied and carried out till nowadays, and the future therapies that may be a hope in this complex and serious disease. We have provided a narrative review after having analyzed the literature and we have selected more than 120 papers to deliver this article.Expert opinion Although in 2023 has been carried out the first FDA approved drugs, there is still a long way to go in developing effective therapies for dry-AMD. In the future, a better understanding of its pathogenesis may lead to the development of targeted or genetic therapies that not only have an anatomical effect on the retina but also have a functional impact.KEYWORDS: Age related macular degenerationGeographic atrophydrusencomplement inhibitorsneuroprotectiongenetic therapyintravitreal injectionDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Article highlightsIn this review we have summarized the most important molecules and trials that have been carried out till now in the attempt to treat dry-AMD.AREDS nutritional supplementation remains the standard of care for dry-AMD.In 2023 FDA has approved the first proven effect therapies for dry-AMD: Pegcetacoplan, and Avacincaptad Pegol.In the future, a genetic therapy focused on preventing and blocking the development of dry-AMD could be the most effective treatment, but at the present time, its development is at the embryonic stage.Declaration of InterestsR Sacconi has the following disclosures: Allergan Inc, Bayer Shering-Pharma, Medivis, Novartis, Zeiss.G Querques has the following disclosures: Alimera Sciences, Allergan Inc, Amgen, Bayer Shering-Pharma, Heidelberg, KBH, LEH Pharma, Lumithera, Novartis, Sandoz, Sifi, Sooft-Fidea, Zeiss.F Bandello has the following disclosures: Alcon (consultant), Alimera Sciences (consultant), Allergan Inc (consultant), Farmila-Thea (consultant), Bayer Shering-Pharma (consultant), Bausch and Lomb Genentech (consultant), Hoffmann-La-Roche (consultant), Novagali Pharma (consultant), Novartis (consultant), Sanofi-Aventis (consu","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135590464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimizing the risk of endophthalmitis following cataract surgery: Current antibiotic approaches","authors":"Nimesh C. Patel, Avinash Pathengay, Mudit Tyagi, Rajeev Reddy Pappuru, Vivek Pravin Dave","doi":"10.1080/17469899.2023.2264508","DOIUrl":"https://doi.org/10.1080/17469899.2023.2264508","url":null,"abstract":"ABSTRACTIntroduction Cataract surgery is the most commonly performed intraocular surgery all over the world. Endophthalmitis is a sight-threatening complication subsequent to intraocular procedures, open-globe injuries, metastatic systemic infections, and systemic inflammatory diseases. The incidence of post-cataract surgery endophthalmitis is 0.012% to 1.3%.Areas covered Patients’ ocular surface flora, surgical instruments, and surgical complications like posterior capsule rupture with vitreous loss and anterior vitrectomy. The most common bacteria causing post-cataract endophthalmitis in the Western world are gram-positive coagulase-negative Staphylococci, followed by Streptococci and Pseudomonas aeruginosa. Povidone-iodine (PI) is the only topical prophylactic antiseptic known to reduce endophthalmitis perioperatively with a three to five times reduction rate within one minute of irrigation. The European Society of Cataract & Refractive Surgeons (ESCRS) study recommendations are also discussed.Expert opinion There are no randomized controlled trials of PI with endophthalmitis rate as the primary end point. Based on retrospective data, 5% PI applied to conjunctiva prior to surgery reduced endophthalmitis rates four-fold. Intracameral injection of either vancomycin, cefazoline, cefuroxime, or moxifloxacin has a prophylactic effect. We recommend using preoperative 5% povidone-iodine for 30 seconds in the cul-de-sac and intracameral moxifloxacin or cefuroxime as effective prophylaxis against post-operative endophthalmitis.KEYWORDS: Endophthalmitisprophylaxisintracameral antibioticsintracameral moxifloxacinpovidone-iodineDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Declaration of interestThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Table 2 Identified Risk factors and associationDownload CSVDisplay TableAdditional informationFundingThis paper was supported by funds from the Hyderabad Eye Research Foundation.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135385927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of collagen matrix as adjuvant to open bleb revision with mitomycin C following failed trabeculectomy","authors":"Jae-Chiang Wong, Jordan Safran, Shahin Hallaj, Eric Shiuey, Connie Wu, Daniel Lee","doi":"10.1080/17469899.2023.2263170","DOIUrl":"https://doi.org/10.1080/17469899.2023.2263170","url":null,"abstract":"ABSTRACTIntroduction Trabeculectomy (TB) with mitomycin C (MMC) is a mainstay of glaucoma surgery for intraocular pressure reduction and visual field preservation, but surgical outcomes are often limited by episcleral and subconjunctival fibrosis leading to intraocular pressure (IOP) spikes.Research Design and Methods Retrospective case series presents seven eyes at a tertiary glaucoma center where open bleb needling was performed in combination with a collagen matrix implant and MMC following failed TB due to excessive fibrosis.Results Seven eyes of seven patients were included. Baseline IOP was 23.9 (±7.4) mmHg with a significant decrease on post-operative (post-op) day 1 to 4.6 mmHg. By post-op month 1, all eyes maintained a non-hypotonus IOP ≥ 5. Notably, four eyes (57%) had at least 1 unsuccessful open bleb needling without a collagen matrix implant prior. All eyes were complication-free by the latest visit without any complication-related visual decline, and six eyes (86%) were glaucoma medication-free at the most-recent post-op follow-up (12.4 ± 11.4 months). All cases were performed by one experienced glaucoma subspecialist (author DL).Conclusions Open bleb needling and MMC in combination with a collagen matrix implant may result in improved and sustained IOP control for encapsulated blebs following failed trabeculectomy, especially in those with prior unsuccessful bleb revisions.KEYWORDS: Ologenglaucomacollagen matrixbleb revisionfailed trabeculectomy Author contributionsAll authors made significant contributions to the research design and to the preparation of the manuscript. J.C. Wong, J. Safran, S. Hallaj and D. Lee were responsible for the execution of the research and data acquisition. J.C. Wong was responsible for the data analysis and interpretation.Declaration of interestD. Lee has received research support from Allergan, Equinox, Glaukos, Mati, Nicox, Olleyes, and Santan, lecture fees from Glaukos, and consulting fees from Quidel Eye Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Additional informationFundingThis paper was not funded.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135816186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic releasing contact lenses: the future of treatment for corneal infection and injury?","authors":"Alex Hui","doi":"10.1080/17469899.2023.2262766","DOIUrl":"https://doi.org/10.1080/17469899.2023.2262766","url":null,"abstract":"","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136060807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms for the symptoms of dryness in soft contact lens wearers","authors":"Charles W McMonnies","doi":"10.1080/17469899.2023.2259613","DOIUrl":"https://doi.org/10.1080/17469899.2023.2259613","url":null,"abstract":"ABSTRACTIntroduction Dryness symptoms in soft contact lens (SCL) wearers are common, especially at the end of the day, and are the most common reason for discontinuing wear.Areas covered With references to mechanisms for dry eye syndromes in non-SCL wearers, this review examines mechanisms whereby dryness symptoms are generated during SCL wear, including the significance of endogenous tear dysfunctions, pre-lens tear film instability, post-lens tear film volumes and stagnation, tear hyperosmolarity, blink inefficiency, SCL material dehydration, and front surface biocompatibility and wetness.Expert opinion Numerous efforts have been made to reduce dryness symptoms by improving SCL materials and surfaces, but the prevalence of dryness symptoms remains stubbornly high. It is possible that symptoms might be due to neuropathy and associated increases in corneal and/or lid wiper sensitivity that develops during SCL wear. For example, over time sensory thresholds for SCL awareness may be lowered and/or conditions that increase their perception sharpened. There are several mechanisms for contributions to thinner pre-lens tear films and reduced SCL biocompatibility. Dryness symptoms may occur with bandage SCL, perhaps especially in a previous wearer of SCL.KEYWORDS: Dry eyecontact lensOcular surfaceCorneaTearssymptomsDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Declaration of interestsThe author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Article highlightsEvidence does not support the expectation that the division of the pre-corneal tear film into two layers by a SCL is a contributor to subsequent quantitative or qualitative aqueous, lipid or mucus deficiency and the risk of lens dehydration.Any SCL-related reduction in aqueous production, combined with increased rates of aqueous loss by evaporation (shorter TBUT), could explain lower tear meniscus heights during SCL wear.Insulation of the cornea from normal atmospheric blink stimuli by a SCL may contribute to aqueous production deficiency and/or blink inefficiency, with associated increased lens drying. For example, corneal insulation from blink stimuli such as exposure to air movement, dust and po","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134970228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of three-dimensional printing technology in Oculoplastic and Orbital Surgery: updates and trends","authors":"Steffani Krista Someda, Yasuhiro Takahashi","doi":"10.1080/17469899.2023.2267757","DOIUrl":"https://doi.org/10.1080/17469899.2023.2267757","url":null,"abstract":"","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134949742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the diagnosis of ocular tuberculosis","authors":"S. Handa, Hind Amin, Atul Arora, R. Agrawal, Vishali Gupta","doi":"10.1080/17469899.2023.2255746","DOIUrl":"https://doi.org/10.1080/17469899.2023.2255746","url":null,"abstract":"ABSTRACT Introduction Ocular tuberculosis (OTB) is a significant cause of visual morbidity and can have varied clinical manifestations. Recent advances in imaging and molecular diagnostic methods have greatly improved our understanding of the disease process. We conducted a search of published articles related to the diagnosis of ocular tuberculosis as of December 2021. Keywords were used to search the databases. Databases that were searched included PubMed and Scopus. Areas covered This review highlights the role of novel imaging modalities including ultra-widefield fundus photography, widefield fluorescein angiography, widefield indocyanine green angiography, swept-source optical coherence tomography, and optical coherence tomography angiography in the diagnosis of OTB. Radiological, immunological, and molecular diagnostic methods and their role in diagnosis of OTB have been discussed as well. Expert opinion With recent advancements in imaging, radiological, immunological, and molecular diagnostic methods, it is now possible to diagnose and treat ocular tuberculosis with greater accuracy, resulting in better treatment outcomes.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41406189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can artificial intelligence be used to improve the quality of vision in patients with amblyopia? The first digital pill in medicine administered under AI","authors":"R. Hess, B. Thompson","doi":"10.1080/17469899.2023.2248393","DOIUrl":"https://doi.org/10.1080/17469899.2023.2248393","url":null,"abstract":"We live in an ever-increasing digital world, digital applications and diagnostics are part and parcel of everyday clinical practice, particularly in Ophthalmology. All previous digital applications have been directed to improving our diagnostic capabilities but now, for the first time there is a digital pill. This is not a digitally activated/tracked pharmaceutical [1], this is a digital treatment per se, one designed to recover visual function in later life that had been lost in childhood. The neural substrate for this is residual neural plasticity present after the early critical period for visual development. There appear to be two pathways, a bottom-up one that is reliant on the appropriate dichoptic stimulation [2] while the other is a top-down one from higher brain areas that involves attention [3–5]. Treatment efficacy depends on activation of both pathways and there is an important role for AI in ensuring that attention is fully engaged for the duration of the bottom-up stimulation which is administered on a videogaming platform suitable for engaging young children.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49067560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in dry eye","authors":"J. Aquavella, Esteban Santiago, J. Zavislan","doi":"10.1080/17469899.2023.2258285","DOIUrl":"https://doi.org/10.1080/17469899.2023.2258285","url":null,"abstract":"The ‘Dry Eye’ definition has matured and evolved over time motivated by advances in technology, knowledge, and understanding of the disease. When TFOS DEWS first presented a definition in 2007, it was defined as a ‘multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface.’ In 2017, the same group added to the definition the concept of ‘loss of homeostasis of the tear film,’ ‘hyperosmolarity,’ ‘inflammation,’ and ‘neurosensory abnormalities.’ All these made a more complete definition of this complex and multifactorial condition [1]. In 2017, the Asia Dry Eye Society (ADES) describes and emphasizes the concept of ‘unstable tear film’ in their definition of dry eye creating a simpler classification oriented to creating a simpler diagnosis and management of these patients [2]. Nowadays, thanks to proliferative research and hard work of different societies to try to bring clarity to a disorder with a high level of complexity, the multifactorial characteristic of Dry Eye Disease is better understood, as is the concept of the lacrimal functional unit (LFU) and its role in the production and maintenance of a healthy ocular surface tear film [3,4].","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139363092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current advances in the management of optic disc pit maculopathy","authors":"D. Shukla, Jay Kalliath, A. Dhawan","doi":"10.1080/17469899.2023.2258284","DOIUrl":"https://doi.org/10.1080/17469899.2023.2258284","url":null,"abstract":"ABSTRACT Introduction Although we have been familiar with optic disc pits for a long time, the diagnosis and management of maculopathy remain unclear. Better imaging has improved the diagnosis of this subtle pathology. A recent update on the natural history of optic pit maculopathy marks a paradigm shift in the understanding and management of this condition. There is renewed scope for non-surgical management and less urgency for vitrectomy, which remains the definitive treatment. Areas covered This perspective highlights and critiques the updates on diagnostic imaging, natural history, indications and prognosis for surgery, non-surgical alternatives, and surgical adjuncts. We searched the Medline database using the keywords optic pit AND maculopathy, optic pit AND macular schisis, optic pit AND macular detachment; optic pit AND vitrectomy, optic pit AND laser photocoagulation, and included the salient articles. Expert commentary There has been no major change in the surgical options and outcomes for optic pit maculopathy in recent times, except a greater clarity on the role of vitrectomy without any adjuvants as the primary surgical procedure. The key updates are on better imaging for diagnosis and prognosis, and less urgency for surgery in view of the favorable natural history.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139363243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}