Expert Review of Ophthalmology最新文献_第6页

Crosslinking for progressive keratoconus: is there room for improvement? 交联治疗进展性圆锥角膜:还有改进的余地吗?

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-03-04 DOI: 10.1080/17469899.2023.2207010

C. Mazzotta, Manuela Pulvirenti, Marco Zagari, S. Jihad, Ashraf Armia Balamoun

{"title":"Crosslinking for progressive keratoconus: is there room for improvement?","authors":"C. Mazzotta, Manuela Pulvirenti, Marco Zagari, S. Jihad, Ashraf Armia Balamoun","doi":"10.1080/17469899.2023.2207010","DOIUrl":"https://doi.org/10.1080/17469899.2023.2207010","url":null,"abstract":"ABSTRACT Introduction the review reports the results of photodynamic accelerated crosslinking (ACXL) protocols focusing on the novelties of high fluence pulsed light transepithelial (Epi-On) ACXL treatments. Areas covered Review covers the outcomes of accelerated crosslinking (ACXL) for all thickness ectatic corneas, including the new epithelium-on (Epi-On) strategies with progressively enhanced fluence, higher riboflavin concentrations and pulsed light irradiation that are considered a promising way forward of photodynamic CXL therapy of Keratoconus (KC), addressing the role of CXL in combination with excimer laser corneal remodeling and lamellar keratoplasty. Literature research is focused on advancements in transepithelial procedures and high fluence accelerated crosslinking treatments looking at CXL plus combined procedures. Expert opinion Today CXL can be considered to all intents a customized corneal photodynamic therapy (CPDT) of ectasia with different application modalities. ACXL protocols optimized the clinical workflow and patient compliance reducing the time of treatment to 20–25 minutes, adapting fluence, improving oxygen kinetic and riboflavin loading. Standardized protocols for thin corneas improved the issue of thin corneas. High irradiance pulsed light Epi-ON ACXL performed with and without iontophoresis, at air-room oxygenation or adding intraoperative supplemental oxygen, reduced the gap of efficacy with Epi-Off techniques, creating the conditions for transition to the Epi-On.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42445786","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}

引用次数: 0

Herpes simplex keratitis (HSK) local treatment guideline audit 2018–2019 单纯疱疹性角膜炎(HSK)局部治疗指南审核2018-2019年

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-03-04 DOI: 10.1080/17469899.2023.2205124

A. Nguyen, Maria Cabrera-Aguas, S. Watson

{"title":"Herpes simplex keratitis (HSK) local treatment guideline audit 2018–2019","authors":"A. Nguyen, Maria Cabrera-Aguas, S. Watson","doi":"10.1080/17469899.2023.2205124","DOIUrl":"https://doi.org/10.1080/17469899.2023.2205124","url":null,"abstract":"ABSTRACT Background The aim of this paper is to report the adherence of clinician prescription to the evidence-based herpes simplex keratitis (HSK) guideline at the Sydney Eye Hospital, Australia, in order to assess the sustainability of guideline implementation. Methods A retrospective review was conducted of patients, aged 18 years and above, receiving anti-viral treatment for HSK at the Sydney Eye Hospital from 1 January 2018 to 31 December 2019. Patients were identified from pharmacy records, viral swab results, and hospital coding data. Results Three hundred and thirty-six eyes of 335 patients, median age 58 years (range 18–103); 61% males were included. Anti-viral therapy was given for therapeutic and prophylactic indications at presentation in 287 (86%) and 48 (14%) patients, respectively. The dose of prescribed antivirals was in alignment with the guidelines in 69% (231/335) of eyes compared to 75% (64/85) in 2017 (P = 0.254) in our prior study. For the type of HSK, alignment with the guidelines was found in 80/112 eyes (71%) with epithelial, 43/68 (63%) with stromal, 13/17 (76%) with endothelial, 52/90 (58%) with keratouveitis, and 43/48 (90%) on prophylaxis. Conclusions Clinicians were similarly adherent to a HSK treatment guideline 2 years after its implementation. Regular activities are needed to sustain knowledge.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44941872","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}

引用次数: 0

Crowdsourcing and its applications to ophthalmology 众包及其在眼科中的应用

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-03-04 DOI: 10.1080/17469899.2023.2200935

Junsang Cho, Wendy Zhang, Grayson W. Armstrong, Daniel Cho, S. Culican

{"title":"Crowdsourcing and its applications to ophthalmology","authors":"Junsang Cho, Wendy Zhang, Grayson W. Armstrong, Daniel Cho, S. Culican","doi":"10.1080/17469899.2023.2200935","DOIUrl":"https://doi.org/10.1080/17469899.2023.2200935","url":null,"abstract":"ABSTRACT Introduction The aim of this study was to review the literature on the application of crowdsourcing in the field of ophthalmology. As the concept of crowdsourcing continues to receive interest, this review describes an analysis of the benefits, limitations, and future directions of crowdsourcing in the context of specific cases. A search of major research databases was performed to identify articles with specific reference to crowdsourcing within the field of ophthalmology. Seventeen total studies used crowdsourcing in a branch of ophthalmology. Crowdsourcing was used in three capacities: evaluation of ophthalmic imaging, collection of data, and assessment of surgery or surgical outcomes. Crowdsourcing holds the potential for rapid, economic data processing and reducing the task burden on experts. The main limitation of crowdsourcing is the potential for error due to inexperience of lay assessors. Areas covered Crowdsourcing was applied in three capacities: evaluation of ophthalmic imaging, collection of data, and assessment of surgery or surgical outcomes. Expert opinion Crowdsourcing has been utilized within ophthalmology and holds potential for rapid, economical data processing and reducing task burden on experts. While the use of crowdsourcing may still be nascent, prior reports indicate promise. This report aims to show how crowdsourcing has been applied in ophthalmology. The main limitation of crowdsourcing has been the potential for error due to lay assessor inexperience, though a potential solution is to use trained assessors. We hope to highlight the past, present, and future of crowdsourcing within ophthalmology through this comprehensive review.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41596300","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}

引用次数: 0

OMNI® surgical system versus iStent inject® with concomitant cataract surgery for the treatment of mild-to-moderate primary open-angle glaucoma in the United States: a cost utility analysis 在美国，OMNI®手术系统与iStent®注射合并白内障手术治疗轻至中度原发性开角型青光眼的成本效用分析

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-03-04 DOI: 10.1080/17469899.2023.2193685

Roberta Longo, Federico Ghinelli, Francesca Torelli, Gregory Mader, C. Masseria, Chad Patel, D. Franic, Jamie Dickerson, Dan Nguyen, L. Cantor

{"title":"OMNI® surgical system versus iStent inject® with concomitant cataract surgery for the treatment of mild-to-moderate primary open-angle glaucoma in the United States: a cost utility analysis","authors":"Roberta Longo, Federico Ghinelli, Francesca Torelli, Gregory Mader, C. Masseria, Chad Patel, D. Franic, Jamie Dickerson, Dan Nguyen, L. Cantor","doi":"10.1080/17469899.2023.2193685","DOIUrl":"https://doi.org/10.1080/17469899.2023.2193685","url":null,"abstract":"ABSTRACT Background A Markov model was developed to investigate the cost utility of the OMNI® Surgical System (OMNI®) versus iStent inject® in patients with mild to moderate primary open angle glaucoma (POAG) during concomitant cataract surgery from a US Medicare perspective. Methods For patients aged 65 years and older with mild to moderate POAG and visually significant cataract, we simulated progression through four glaucoma states (mild, moderate, advanced, severe) and death, using 6-month cycles and a lifetime horizon. A systematic literature review identified effectiveness data to calculate health state transition probabilities. Direct costs included surgical procedures, physician fees, and intraocular pressure (IOP)-lowering medications using Medicare 2022 rates. Utilities were sourced from published literature. Model structure and inputs were validated by a panel of ophthalmologists in the US and UK. Main outcome measures were incremental cost/QALY gained and net monetary benefit (NMB). Results OMNI® dominated iStent inject® with $552 lower costs and a gain of 0.02 quality-adjusted life-years. Model robustness was tested through deterministic and probabilistic sensitivity analyses, with OMNI® being dominant or cost-effective. NMB was $1,422 using a $50,000 willingness-to-pay threshold. Conclusion OMNI® was less costly and more effective than iStent inject® over a lifetime perspective for mild-to-moderate POAG Medicare patients in need of cataract extraction.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47535788","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}

引用次数: 1

Integrating artificial intelligence into an ophthalmologist’s workflow: obstacles and opportunities 将人工智能集成到眼科医生的工作流程中:障碍和机遇

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-01-02 DOI: 10.1080/17469899.2023.2175672

P. Taribagil, H. J. Hogg, K. Balaskas, P. Keane

{"title":"Integrating artificial intelligence into an ophthalmologist’s workflow: obstacles and opportunities","authors":"P. Taribagil, H. J. Hogg, K. Balaskas, P. Keane","doi":"10.1080/17469899.2023.2175672","DOIUrl":"https://doi.org/10.1080/17469899.2023.2175672","url":null,"abstract":"ABSTRACT Introduction Demand in clinical services within the field of ophthalmology is predicted to rise over the future years. Artificial intelligence, in particular, machine learning-based systems, have demonstrated significant potential in optimizing medical diagnostics, predictive analysis, and management of clinical conditions. Ophthalmology has been at the forefront of this digital revolution, setting precedents for integration of these systems into clinical workflows. Areas covered This review discusses integration of machine learning tools within ophthalmology clinical practices. We discuss key issues around ethical consideration, regulation, and clinical governance. We also highlight challenges associated with clinical adoption, sustainability, and discuss the importance of interoperability. Expert opinion Clinical integration is considered one of the most challenging stages within the implementation process. Successful integration necessitates a collaborative approach from multiple stakeholders around a structured governance framework, with emphasis on standardization across healthcare providers and equipment and software developers.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43996635","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}

引用次数: 0

A review of dry eye disease therapies: exploring the qualities of varenicline solution nasal spray 干眼病治疗综述:探讨伐尼克兰鼻喷雾剂的质量

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-01-02 DOI: 10.1080/17469899.2023.2173173

S. Bhargava, Ranjani Panda, Asma M. Azam, J. Sheppard

引用次数: 0

Upper blepharoplasty: advanced techniques and adjunctive procedures 上眼睑整形术：先进的技术和辅助程序

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-01-02 DOI: 10.1080/17469899.2023.2175673

Parya Abdolalizadeh, M. Kashkouli, Vahid Khamesi, N. Karimi, Hossein Ghahvehchian, L. Ghiasian

{"title":"Upper blepharoplasty: advanced techniques and adjunctive procedures","authors":"Parya Abdolalizadeh, M. Kashkouli, Vahid Khamesi, N. Karimi, Hossein Ghahvehchian, L. Ghiasian","doi":"10.1080/17469899.2023.2175673","DOIUrl":"https://doi.org/10.1080/17469899.2023.2175673","url":null,"abstract":"ABSTRACT Introduction Various techniques of upper blepharoplasty are used to correct dermatochalasis as the common sign of aging in periorbital areas. Most patients seeking upper eyelid rejuvenation have other involutional changes in upper face which can be addressed as adjunct to upper blepharoplasty procedure to yield better esthetic and functional outcomes. Areas covered The aim of the present study is to review current concepts in preoperative considerations, surgical techniques, and adjuvant procedures of upper blepharoplasty. The role of social media is also discussed in this arena. A literature search was performed in PubMed database of English-language journals with no restriction on the date of publication using selected keywords. The relevant articles were selected by reviewing the titles and abstracts. Expert opinion Careful preoperative examination of midface and upper face is necessary to assess concomitant ageing deformities besides dermatochalasis. Nowadays, volume preservation approach is the mainstream in upper blepharoplasty. Upper blepharoplasty incisions can be used to address lacrimal gland prolapse, blepharoptosis, Asian medial epicanthoplasty and eyebrow ptosis in selected individuals.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44803106","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}

引用次数: 0

Corneal transplantation in children - when and how? 儿童角膜移植-何时以及如何进行?

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-01-02 DOI: 10.1080/17469899.2023.2177153

Abha Gour, A. Garg, Shailja Tibrewal, Julie Pegu, Sonal Gupta, Umang Mathur, V. Sangwan

{"title":"Corneal transplantation in children - when and how?","authors":"Abha Gour, A. Garg, Shailja Tibrewal, Julie Pegu, Sonal Gupta, Umang Mathur, V. Sangwan","doi":"10.1080/17469899.2023.2177153","DOIUrl":"https://doi.org/10.1080/17469899.2023.2177153","url":null,"abstract":"ABSTRACT Introduction Advanced surgical techniques, better post-operative protocols, imaging, and better understanding of genetic basis have enhanced outcomes of pediatric keratoplasty. However, results in infants and younger children remain a challenge. Transplants in the pediatric age group are challenging because of the complexity of the indications, the procedure itself, and the problems with respect to follow-up and post-operative care in younger recipients. Areas covered This review presents an overview of challenges faced in the management of pediatric corneal grafts, and problems encountered in long-term survival. We discuss the changing trends in these outcomes of PKP with a current review of the recent literature from PubMed. We also share the results of pediatric keratoplasty done at our center in the last three years and have an in-depth discussion about the management of comorbidities like cataracts and glaucoma Expert opinion Despite several advances in microsurgical techniques for corneal transplantation, pediatric keratoplasty remains challenging due to a variety of factors such as young age, repeated need for anesthesia, immature ocular tissues, and accelerated healing. The advent of component surgeries like DALK, DSEK, and DMEK has improved outcomes and simplified management options. Even after specialized surgeries, long-term follow-ups and management of comorbidities become essential.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48727120","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}

引用次数: 1

Factors affecting the prevalence, severity, and characteristics of ocular surface pain. 影响眼表疼痛发生率、严重程度和特征的因素。

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-01-01 Epub Date: 2022-12-18 DOI: 10.1080/17469899.2023.2157813

Victor Sanchez, Noah K Cohen, Elizabeth Felix, Anat Galor

{"title":"Factors affecting the prevalence, severity, and characteristics of ocular surface pain.","authors":"Victor Sanchez, Noah K Cohen, Elizabeth Felix, Anat Galor","doi":"10.1080/17469899.2023.2157813","DOIUrl":"10.1080/17469899.2023.2157813","url":null,"abstract":"Introduction: Ocular surface pain has been traditionally lumped under the umbrella term \"dry eye\" (DE) but is now understood as its own entity and can occur in the absence or presence of tear dysfunction. Identifying patients at risk for the development of chronic ocular surface pain, and factors contributing to its severity are important in providing precision medicine to patients.Areas covered: In this review, we discuss factors linked to the presence and severity of ocular surface pain, including eye related features, systemic characteristics, and environmental findings. We discuss corneal nerves, whose anatomic and functional integrity can be characterized through in vivo confocal microscopy images and testing of corneal sensitivity. We review systemic diseases that are co-morbid with ocular surface pain, including physical and mental health diagnoses. Finally, we identify environmental contributors, including air pollution, previous surgeries, and medications, associated with ocular surface pain.Expert opinion: Intrinsic and extrinsic factors contribute to ocular surface pain and must be considered when evaluating an individual patient. These factors can inform the suspected etiology of the pain, and guide management decisions such as tear replacement or medications targeting nerve pain.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9287616","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}

引用次数: 0

Emerging glaucoma treatments: are we seeing an improvement in adherence? 新兴的青光眼治疗方法：我们是否看到依从性有所改善？

IF 0.7

Expert Review of Ophthalmology Pub Date : 2023-01-01 Epub Date: 2023-04-12 DOI: 10.1080/17469899.2023.2199981

Andrew P Droste, Paula Anne Newman-Casey

{"title":"Emerging glaucoma treatments: are we seeing an improvement in adherence?","authors":"Andrew P Droste, Paula Anne Newman-Casey","doi":"10.1080/17469899.2023.2199981","DOIUrl":"10.1080/17469899.2023.2199981","url":null,"abstract":"Introduction: Non-adherence to glaucoma medication and poor follow-up is a global health concern.Areas covered: Glaucoma remains one of the largest causes of irreversible blindness worldwide. Traditional treatment guidelines suggest topical eye drop medication as first line therapy followed by addition of supplementary medications before proceeding to more invasive glaucoma surgeries. Unfortunately, poor glaucoma self-management remains high, leading to disease progression and blindness. Recent advancements in the field of pharmacotherapies, surgeries, and behavioral approaches have taken aim at increasing support for glaucoma self-management. We review the current and emerging approaches towards glaucoma management, with the exception of bleb-based surgical approaches, to investigate if they have had an impact on adherence. Literature searches were conducted via MEDLINE (PubMed), Embase (Elsevier), Cochrane Library (Wiley), and Preprints from January 1st, 2018, to January 26th, 2023.Expert opinion: The ability to offer patients a multitude of choices enables patients to tailor their glaucoma treatment to their values and lifestyle. Offering personalized patient education and coaching to support chronic glaucoma self-management would better enable patient engagement in whichever treatment path is chosen. Currently, literature regarding the impact of these new advancements on treatment engagement is lacking; this field is ripe for additional intervention and assessment.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10300338","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}

引用次数: 0