Saudi Journal of Ophthalmology最新文献

{"title":"Monoclonal antibody therapies for aquaporin-4-immunoglobulin G-positive neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease.","authors":"Nanthaya Tisavipat, Hui Y Juan, John J Chen","doi":"10.4103/sjopt.sjopt_102_23","DOIUrl":"10.4103/sjopt.sjopt_102_23","url":null,"abstract":"<p><p>Monoclonal antibody therapies mark the new era of targeted treatment for relapse prevention in aquaporin-4 (AQP4)-immunoglobulin G (IgG)-positive neuromyelitis optica spectrum disorder (AQP4-IgG+NMOSD). For over a decade, rituximab, an anti-CD20 B-cell-depleting agent, had been the most effectiveness treatment for AQP4-IgG+NMOSD. Tocilizumab, an anti-interleukin-6 receptor, was also observed to be effective. In 2019, several randomized, placebo-controlled trials were completed that demonstrated the remarkable efficacy of eculizumab (anti-C5 complement inhibitor), inebilizumab (anti-CD19 B-cell-depleting agent), and satralizumab (anti-interleukin-6 receptor), leading to the Food and Drug Administration (FDA) approval of specific treatments for AQP4-IgG+NMOSD for the first time. Most recently, ravulizumab (anti-C5 complement inhibitor) was also shown to be highly efficacious in an open-label, external-controlled trial. Although only some patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) warrant immunotherapy, there is currently no FDA-approved treatment for relapse prevention in MOGAD. Observational studies showed that tocilizumab was associated with a decrease in relapses, whereas rituximab seemed to have less robust effectiveness in MOGAD compared to AQP4-IgG+NMOSD. Herein, we review the evidence on the efficacy and safety of each monoclonal antibody therapy used in AQP4-IgG+NMOSD and MOGAD, including special considerations in children and women of childbearing potential.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 1","pages":"2-12"},"PeriodicalIF":0.6,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11017007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862673","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":"Retinitis pigmentosa GTPase regulator-related retinopathy and gene therapy.","authors":"Nida Wongchaisuwat, Alessia Amato, Andrew E Lamborn, Paul Yang, Lesley Everett, Mark E Pennesi","doi":"10.4103/sjopt.sjopt_168_23","DOIUrl":"10.4103/sjopt.sjopt_168_23","url":null,"abstract":"<p><p>Retinitis pigmentosa GTPase regulator <i>(RPGR)</i>-related retinopathy is a retinal dystrophy inherited in a X-linked recessive manner that typically causes progressive visual loss starting in childhood with severe visual impairment by the fourth decade of life. It manifests as an early onset and severe form of retinitis pigmentosa. There are currently no effective treatments for <i>RPGR</i>-related retinopathy; however, there are multiple clinical trials in progress exploring gene augmentation therapy aimed at slowing down or halting the progression of disease and possibly restoring visual function. This review focuses on the molecular biology, clinical manifestations, and the recent progress of gene therapy clinical trials.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 4","pages":"276-286"},"PeriodicalIF":0.4,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10752277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058884","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":"Presumed uremic optic neuropathy in a patient with Senior-Loken syndrome.","authors":"Arif O Khan","doi":"10.4103/sjopt.sjopt_140_23","DOIUrl":"10.4103/sjopt.sjopt_140_23","url":null,"abstract":"<p><p>A patient who had been diagnosed with infantile retinal dystrophy developed renal failure in his twenties, at which time the diagnosis was revised to Senior-Loken syndrome. He was poorly compliant. At 36 years old, he experienced a sudden drop in visual acuity in the setting of cramping and fatigue and was found to be in uremic crisis. Six months after the event and its treatment, his vision failed to improved. Optic nerve pallor was out of proportion to the retinal dystrophy, and the presumed reason for his new visual loss was uremic optic neuropathy. The patient's younger sister also had been diagnosed with infantile retinal dystrophy, and metabolic screening confirmed subclinical renal dysfunction that was to be carefully followed going forward. Infantile retinal dystrophy can be associated with later systemic disease. Early detection of such disease can potentially decrease morbidity. Patients with retinal dystrophy can develop new visual loss from causes other than the retinopathy itself.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 4","pages":"310-312"},"PeriodicalIF":0.4,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10752282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058883","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":"Parental experience with an ocular genetic counseling services in Saudi Arabia.","authors":"Areej Alizary, Khabir Ahmad, Amani Al Bakri","doi":"10.4103/sjopt.sjopt_154_23","DOIUrl":"10.4103/sjopt.sjopt_154_23","url":null,"abstract":"<p><strong>Purpose: </strong>This study reports parental attitudes towards preimplantation genetic diagnosis (PGD) and their satisfaction with genetic counseling services offered by a territory eye care hospital in Saudi Arabia.</p><p><strong>Methods: </strong>This was a cross-sectional study of 30 parents (either father or mother) of children affected by recessive genetic ocular disorders. Their basic knowledge of recessive genetic disorders, attitude toward PGD, and satisfaction with counseling services were assessed using structured telephonic interviews.</p><p><strong>Results: </strong>Eighty percent of the participants understood the concept of recessive inheritance patterns and the effect of consanguineous marriages on raising the likelihood of giving birth to a child with genetic disorders. Forty-seven percent of parents understood the risk of having an affected future offspring. Sixty-seven percent of them mentioned that they would consider using preventive measures when conceiving next time. Seventy-three percent of participants stated that they would share the genetic test results with family members. Ninety percent of the parents were satisfied with the genetic counselor's ability to listen to them and the way the counselor explained the genetic information. There was a statistically significant association between parental willingness to share genetic test results with relatives and being given the opportunity to share information with their genetic counselor (<i>P</i> = 0.01). There was no association between the parental's knowledge and their willingness to consider using preventative measures in the next pregnancy.</p><p><strong>Conclusion: </strong>Most parents had a basic understanding of recessive disease. However, they often struggled to comprehend the science and mathematical probabilities determining the recurrence risk in future pregnancies. This complexity makes it difficult for them to recall the information. Attitude toward PGD did not seem to be related with parent knowledge. A significant proportion of the parents expressed willingness to share their genetic test results with relatives, but some were hesitant due to fears of stigma. Most parents were satisfied with genetic counseling services.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 4","pages":"296-300"},"PeriodicalIF":0.4,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10752285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058786","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":"Visual parameter status as a predictive factor for the outcomes of occlusion therapy in anisometropic amblyopia.","authors":"Subashree Palani, Sathiskumar Rangasami, Antony A Baskaran","doi":"10.4103/sjopt.sjopt_105_23","DOIUrl":"10.4103/sjopt.sjopt_105_23","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose is to compare visual parameters between normal and amblyopic eyes in anisometropic amblyopia and to find predictive factors for occlusion therapy.</p><p><strong>Methods: </strong>Sixty patients with anisometropic amblyopia between the ages of 5 and 25 years were enrolled in the prospective, longitudinal, and interventional study. Patients were selected based on no improvement with spectacle correction alone after 1 month of follow-up. Baseline parameters such as LogMAR visual acuity, LEA contrast sensitivity, TNO stereopsis test, online Farnsworth D-15 test for color vision, accommodation with RAF ruler, +2.00/-2.00 flipper test, and dynamic retinoscopy were recorded. All patients were treated with occlusion therapy depending on their grades of amblyopia. After 6 months of follow-up, improvement in visual acuity was recorded with a LogMAR chart and correlated with initial visual parameters. Paired \"t\" test, Chi-square test, independent \"t\" test, analysis of variance test were used as statistical analysis.</p><p><strong>Results: </strong>Visual functions such as contrast sensitivity, accommodative facility, near point of accommodation, and accommodative amplitude showed a statistically significant difference between normal and amblyopic eyes of anisometropic amblyopia patients, whereas color vision did not differ significantly between normal and amblyopic eyes. Sixty-seven percentage of patients had poor stereopsis. Eighty percentage of patients who were younger had improvement in final best-corrected visual acuity and these patients had better stereopsis, contrast sensitivity, and mild-to-moderate amblyopia on initial testing.</p><p><strong>Conclusion: </strong>The age of the patient, degree of anisometropia, spherical equivalent in amblyopic eyes, stereopsis, contrast sensitivity values at initial presentation, and compliance to occlusion therapy were found to be positive predictive factors of occlusion therapy.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 3","pages":"286-290"},"PeriodicalIF":0.6,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510216","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":"Intermediate-term outcome of Aurolab aqueous drainage implant in refractory glaucoma.","authors":"Shanu Mittal, Julie Pegu, Darshana Daga, Suneeta Dubey","doi":"10.4103/sjopt.sjopt_117_22","DOIUrl":"10.4103/sjopt.sjopt_117_22","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to evaluate the intermediate-term outcomes of Aurolab aqueous drainage implant (AADI) in terms of intraocular pressure (IOP) lowering from baseline levels, the number antiglaucoma medications (AGMs) in the postoperative phase, and the rate of complications.</p><p><strong>Methods: </strong>It was a retrospective interventional case series. All patients who underwent AADI surgeries with sulcus fixation from March 2018 to September 2018 at a tertiary eye care hospital in North India with a minimum follow-up of 1 year were recruited for the study. A standard AADI technique was employed. The primary outcome measures were the postoperative IOP, the requirement of AGMs, and early and late postoperative complications.</p><p><strong>Results: </strong>A total of 20 patients were recruited in the study. The mean follow-up period was 25.25 ± 3.76 months. The mean IOP reduced from 33.20 ± 7.95 mmHg to 19.45 ± 9.19 mmHg at day 1, 13.62 ± 3.92 mmHg at 6 months, 12.78 ± 3.36 mmHg at 1 year, and 13.0 ± 2.53 mmHg at 2 years postoperatively (<i>P</i> < 0.001). The mean number of AGMs also reduced from 3.7 ± 0.97 to 0.35 ± 0.81 at 6 months, 0.42 ± 0.83 at 1 year, and 0.26 ± 0.73 at 2 years postoperatively (<i>P</i> < 0.001). Early postoperative complications, such as hypotony and hyphema, were seen in 5 (25%) patients, although none of them was sight-threatening. Late postoperative complications, such as hypertensive phase and persistent fibrinous membrane, were also seen in five eyes.</p><p><strong>Conclusion: </strong>The study assessed the clinical outcomes, safety profile, and long-term AGM requirement with AADI and found it to be a good viable surgical option in refractory glaucoma.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 4","pages":"321-326"},"PeriodicalIF":0.4,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10752278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058785","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":"Quality of life and vision assessment with scleral lenses in keratoconus.","authors":"Shivanand R Hadimani, Hardeep Kaur, Amit J Shinde, Tonmoy Chottopadhyay","doi":"10.4103/sjopt.sjopt_157_23","DOIUrl":"10.4103/sjopt.sjopt_157_23","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study is to evaluate the visual outcomes and improvement in quality of life (QOL) of patients with keratoconus with scleral lenses.</p><p><strong>Methods: </strong>In this prospective study, 14 patients (28 eyes) with bilateral keratoconus were fitted with scleral lenses (McAsfeer 16.00 mm) in Pune city, Maharashtra, India. Uncorrected visual acuity (VA), best spectacle-corrected VA, and VA with scleral lenses were evaluated. The patients were given the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) for judging the QOL, before and after using scleral lenses for 3 months.</p><p><strong>Results: </strong>The mean uncorrected VA of the 14 patients with a mean age of 28.64 ± 6.57 years was 1.18 ± 0.19 logMAR. Best spectacle-corrected high-contrast VA improved from 0.47 ± 0.25 logMAR to 0.03 ± 0.07 logMAR with scleral lenses (<i>P</i> < 0.001). Best spectacle-corrected low-contrast VA improved from 0.68 ± 0.22 logMAR to 00.47 ± 0.10 logMAR with scleral lenses (<i>P</i> < 0.001). Along with the increase in overall median scores on the NEI VFQ-25 from 1735 to 2930 points (<i>P</i> < 0.001), the distance and near activities (<i>P</i> < 0.001), vision-specific mental health (<i>P</i> < 0.002), social functioning (<i>P</i> < 0.004), and driving (<i>P</i> < 0.005) improved after using scleral lenses for 3 months.</p><p><strong>Conclusion: </strong>Scleral lenses can be an effective and safe management option for patients with keratoconus leading to an improved vision and QOL.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 2","pages":"173-178"},"PeriodicalIF":0.6,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582026","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":"Techniques in pediatric refractive surgery.","authors":"Kamran Ahmed","doi":"10.4103/sjopt.sjopt_133_23","DOIUrl":"10.4103/sjopt.sjopt_133_23","url":null,"abstract":"<p><p>Pediatric refractive surgery treats refractive errors and their associated comorbidities such as amblyopia and strabismus in special needs children intolerant of spectacles or contact lenses. Children with neurobehavioral disorders undergoing refractive surgery have improvements in visual acuity, communication, socialization, motor skills, adaptive behaviors, visual perception, and cognitive function. Contrary to adults, amblyopia is frequently an indication for refractive surgery in special needs children. Pediatric refractive surgery techniques modify ametropia at the corneal, anterior chamber, posterior chamber, and lens planes. This article will discuss the most common modalities used today in pediatric refractive surgery, including laser keratorefractive surgery, phakic intraocular lenses, and refractive lens exchange. Practical pearls are discussed for the implementation of pediatric refractive surgery, reviewing preoperative diagnostics, surgical techniques, and postoperative care.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 3","pages":"214-220"},"PeriodicalIF":0.6,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510214","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":"Full-field electroretinography - when do we need it?","authors":"Arif O Khan","doi":"10.4103/sjopt.sjopt_126_23","DOIUrl":"10.4103/sjopt.sjopt_126_23","url":null,"abstract":"<p><p>Multimodal imaging and genetic testing allow sophisticated assessment of suspected inherited retinal disease. Given the availability of such technology, some question whether the full-field electrogram (ffERG) is needed anymore. In fact, a ffERG remains essential for certain clinical scenarios. The goal of this case-based review is to provide a clear understanding of what clinical situations warrant a ffERG. All practicing ophthalmologists should be familiar with this information.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 4","pages":"263-268"},"PeriodicalIF":0.4,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10752284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058782","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":"Applications of artificial intelligence-assisted retinal imaging in systemic diseases: A literature review.","authors":"Ali M Al-Halafi","doi":"10.4103/sjopt.sjopt_153_23","DOIUrl":"https://doi.org/10.4103/sjopt.sjopt_153_23","url":null,"abstract":"<p><p>The retina is a vulnerable structure that is frequently affected by different systemic conditions. The main mechanisms of systemic retinal damage are either primary insult of neurons of the retina, alterations of the local vasculature, or both. This vulnerability makes the retina an important window that reflects the severity of the preexisting systemic disorders. Therefore, current imaging techniques aim to identify early retinal changes relevant to systemic anomalies to establish anticipated diagnosis and start adequate management. Artificial intelligence (AI) has become among the highly trending technologies in the field of medicine. Its spread continues to extend to different specialties including ophthalmology. Many studies have shown the potential of this technique in assisting the screening of retinal anomalies in the context of systemic disorders. In this review, we performed extensive literature search to identify the most important studies that support the effectiveness of AI/deep learning use for diagnosing systemic disorders through retinal imaging. The utility of these technologies in the field of retina-based diagnosis of systemic conditions is highlighted.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 3","pages":"185-192"},"PeriodicalIF":0.4,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10701145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812466","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}