Current Opinion in Ophthalmology最新文献_第8页

Challenges and outcomes of cataract surgery after vitrectomy. 玻璃体切除术后白内障手术的挑战和结果。

IF 2.6 2区医学

Current Opinion in Ophthalmology Pub Date : 2025-01-01 Epub Date: 2024-11-08 DOI: 10.1097/ICU.0000000000001096

Bryanna J Lee, Jong Hwa Jun, Natalie A Afshari

{"title":"Challenges and outcomes of cataract surgery after vitrectomy.","authors":"Bryanna J Lee, Jong Hwa Jun, Natalie A Afshari","doi":"10.1097/ICU.0000000000001096","DOIUrl":"10.1097/ICU.0000000000001096","url":null,"abstract":"Purpose of review: This review examines the challenges and outcomes of cataract surgery after pars plana vitrectomy (PPV), focusing on surgical techniques, timing, and complication management.Recent findings: Cataract formation remains the primary complication post-PPV, affecting approximately 80-100% of patients within two years. Nuclear sclerotic cataracts are most common, occurring in 60-100% of patients over 50, followed by posterior subcapsular cataracts (4-34%), which primarily affect younger and diabetic patients. PPV disrupts the normal oxygen gradient in the vitreous, resulting in a more uniform oxygen distribution and accelerating cataract formation.Post-PPV eyes present unique surgical challenges due to anatomical alterations, including zonular instability and capsular changes characterized by increased fragility, the potential for tears, and altered elasticity. Newer intraocular lens power calculations show promise, but unexpected refractive outcomes may occur. The choice between combined phacovitrectomy and sequential surgeries remains debated, with patient-specific factors guiding the approach. Visual outcomes vary depending on preexisting vitreoretinal pathologies and baseline vision before PPV. Further randomized controlled trials are needed to establish treatment guidelines and improve predictive models.Summary: Post-PPV cataract surgery presents unique challenges, including anatomical alterations and an increased risk of capsular complications. These necessitate careful consideration of the surgical approach and highlight the need for further research to optimize outcomes and establish treatment guidelines.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"70-75"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of cataract surgery on lowering intraocular pressure. 白内障手术对降低眼压的影响。

IF 2.6 2区医学

Current Opinion in Ophthalmology Pub Date : 2025-01-01 Epub Date: 2024-11-27 DOI: 10.1097/ICU.0000000000001112

Yesha S Shah, Anupam K Garg, Pradeep Y Ramulu

{"title":"The effect of cataract surgery on lowering intraocular pressure.","authors":"Yesha S Shah, Anupam K Garg, Pradeep Y Ramulu","doi":"10.1097/ICU.0000000000001112","DOIUrl":"10.1097/ICU.0000000000001112","url":null,"abstract":"Purpose of review: To review the literature evaluating the effectiveness of cataract surgery alone and cataract surgery in combination with other procedures and surgeries on intraocular pressure (IOP) in patients with ocular hypertension and glaucoma.Recent findings: Recent studies of large trials have shown the IOP-lowering effect of cataract surgery and the beneficial effect of minimally invasive glaucoma surgery (MIGS). More studies are being published on when to use cataract surgery alone, with MIGS, or with traditional glaucoma surgeries for both primary open angle glaucoma and primary angle closure glaucoma.Summary: Patients with ocular hypertension and visually significant cataracts would benefit from cataract surgery alone to lower intraocular pressure. Patients with mild to moderate glaucoma would likely benefit from cataract surgery and MIGS to achieve a lower IOP. Patients with more advanced glaucoma would benefit from cataract surgery combined with a traditional incisional glaucoma surgery. Clear lens extraction can be used in patients with primary angle closure and early primary angle closure glaucoma. In patients with more advanced disease, phacoemulsification and another glaucoma surgery is likely to be required to achieve IOP control. MIGS are starting to be used in angle closure glaucoma, although more research needs to be done to define its role.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"46-53"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimodal corneal imaging before refractive cataract surgery. 屈光性白内障手术前的多模式角膜成像。

IF 2.6 2区医学

Current Opinion in Ophthalmology Pub Date : 2025-01-01 Epub Date: 2024-10-29 DOI: 10.1097/ICU.0000000000001102

Karolyna Andrade de Carvalho, Louise Pellegrino G Esporcatte, Rachel L R Gomes, Renato Ambrósio

{"title":"Multimodal corneal imaging before refractive cataract surgery.","authors":"Karolyna Andrade de Carvalho, Louise Pellegrino G Esporcatte, Rachel L R Gomes, Renato Ambrósio","doi":"10.1097/ICU.0000000000001102","DOIUrl":"10.1097/ICU.0000000000001102","url":null,"abstract":"Purpose of review: To prospectively review the advances in diagnostics for refractive cataract surgery, focusing on multimodal corneal analysis.Recent findings: The article explores the considerations related to planning refractive cataract surgery, emphasizing its potential to enhance patients' vision performance and quality of life. This review explores preoperative analysis in cataract surgery, focusing on assessing the cornea and ocular surface using multimodal diagnostics, including Placido disk-based corneal topography, Scheimpflug tomography OCT (optical coherence tomography), and biomechanical assessment. Wavefront technology, gene therapy, and artificial intelligence are also relevant in enhancing surgical precision and outcomes. It highlights the importance of preoperative thorough evaluations and technological advancements in ophthalmology.Summary: The rapid evolution and advancement of technology enable excellent refractive outcomes in most cases following cataract surgery. Consideration of appropriate preoperative factors is essential for achieving the desired postoperative outcome.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"25-34"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cataract surgery with endothelial keratoplasty. 白内障手术与内皮角膜移植术。

IF 2.6 2区医学

Current Opinion in Ophthalmology Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI: 10.1097/ICU.0000000000001094

Muhammad A Ahad, Sara M AlHilali, Deema E Jomar

{"title":"Cataract surgery with endothelial keratoplasty.","authors":"Muhammad A Ahad, Sara M AlHilali, Deema E Jomar","doi":"10.1097/ICU.0000000000001094","DOIUrl":"10.1097/ICU.0000000000001094","url":null,"abstract":"Purpose of review: This review aims to provide an updated summary of the combined approach of cataract surgery with endothelial keratoplasty (EK), addressing key considerations, including intraocular lens (IOL) choice and calculation, decision between sequential and triple EK, and modifications in surgical techniques and postoperative management.Recent findings: Advances in imaging techniques (Scheimpflug tomography and anterior segment optical coherence tomography) have improved the ability to detect subclinical corneal edema, aiding in surgical decision-making for EK. Recent studies comparing sequential and triple-EK indicate that both methods yield similar visual outcomes. Though triple-EK offers quicker recovery, it may have higher complication rates. The use of gases like SF6 and C3F8 for anterior chamber tamponade is evolving, with conflicting findings on their efficacy in preventing graft detachment. Furthermore, IOL selection remains crucial, as hyperopic refractive surprises are common, and hydrophilic lenses should be avoided owing to the risk of opacification after EK.Summary: The combination of cataract surgery with EK has emerged as an effective treatment for patients with corneal endothelial diseases and cataract. Careful preoperative evaluation, appropriate IOL selection, and advances in surgical techniques contribute to better outcomes, although patient-specific factors must guide the choice between sequential and triple-EK procedures.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"39-45"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ocular manifestations of West Nile virus. 西尼罗河病毒的眼部表现。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-08-26 DOI: 10.1097/ICU.0000000000001080

James P Dossett, Christine I Clavell, Ghassan Ghorayeb

{"title":"Ocular manifestations of West Nile virus.","authors":"James P Dossett, Christine I Clavell, Ghassan Ghorayeb","doi":"10.1097/ICU.0000000000001080","DOIUrl":"10.1097/ICU.0000000000001080","url":null,"abstract":"Purpose of review: Over the past two decades, the ophthalmic manifestations of West Nile virus have been more clearly established in the literature. This review aims to summarize its diagnosis and pathogenesis, with a focus on its clinical appearance, characteristic imaging features, and management.Recent findings: Ocular manifestations of West Nile virus present early in the disease course and are more common in cases with severe neurological involvement. The use of optical coherence tomography (OCT), optical coherence tomography angiography (OCT-A), fundus autofluorescence (FAF), fluorescein angiogram (FA), and indocyanine green angiography (ICGA) can aid in its diagnosis and management.Summary: West Nile virus infection may present with ocular findings that include anterior uveitis, vitritis, retinitis, chorioretinitis, and optic neuropathy; visual prognosis can range from excellent to poor depending on severity of involvement and the presence of secondary complications, such as occlusive vasculitis and macular ischemia. Diagnosis may be aided by multimodal imaging assessment. The ophthalmologist should have a high clinical suspicion for ocular involvement in cases of severe systemic disease.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"521-525"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ocular toxicities associated with antibody drug conjugates. 与抗体药物共轭物相关的眼部毒性。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-05-30 DOI: 10.1097/ICU.0000000000001063

Rayna F Marshall, Hannah Xu, Meghan Berkenstock

引用次数: 0

Ocular manifestations of juvenile Sjögren's disease. 青少年斯约格伦病的眼部表现。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-06-24 DOI: 10.1097/ICU.0000000000001069

Robert Nguyen, Luis Gomez-Castillo, John A Gonzales

{"title":"Ocular manifestations of juvenile Sjögren's disease.","authors":"Robert Nguyen, Luis Gomez-Castillo, John A Gonzales","doi":"10.1097/ICU.0000000000001069","DOIUrl":"10.1097/ICU.0000000000001069","url":null,"abstract":"Purpose of review: This review aims to enhance understanding of juvenile Sjögren's disease (jSjD) by exploring diagnostic criteria, ocular clinical features, ancillary ophthalmic testing, and management strategies specific to this rare pediatric condition.Recent findings: Unlike adults, children with jSjD often present with recurrent parotitis and extra-glandular symptoms before developing sicca symptoms. Adult SjD classification criteria do not consider pediatric-specific symptoms and physiological differences. Underutilization of diagnostic tests such as the ocular staining score (OSS) and Schirmer I may result in an incomplete understanding of the prevalence of keratoconjunctivitis sicca in jSjD.Summary: Timely referral to an ophthalmologist can address perceived feasibility issues with respect to ocular features in jSjD. Management of keratoconjunctivitis sicca in jSjD includes improving ocular surface lubrication and decreasing inflammation. Recognition of pediatric-specific clinical features and development of universally accepted jSjD classification criteria will allow for better identification of potential participants for future jSjD studies.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"513-520"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Privacy preserving technology in ophthalmology. 眼科隐私保护技术。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-08-26 DOI: 10.1097/ICU.0000000000001087

Yahan Yang, Xinwei Chen, Haotian Lin

{"title":"Privacy preserving technology in ophthalmology.","authors":"Yahan Yang, Xinwei Chen, Haotian Lin","doi":"10.1097/ICU.0000000000001087","DOIUrl":"10.1097/ICU.0000000000001087","url":null,"abstract":"Purpose of review: Patient privacy protection is a critical focus in medical practice. Advances over the past decade in big data have led to the digitization of medical records, making medical data increasingly accessible through frequent data sharing and online communication. Periocular features, iris, and fundus images all contain biometric characteristics of patients, making privacy protection in ophthalmology particularly important. Consequently, privacy-preserving technologies have emerged, and are reviewed in this study.Recent findings: Recent findings indicate that general medical privacy-preserving technologies, such as federated learning and blockchain, have been gradually applied in ophthalmology. However, the exploration of privacy protection techniques of specific ophthalmic examinations, like digital mask, is still limited. Moreover, we have observed advancements in addressing ophthalmic ethical issues related to privacy protection in the era of big data, such as algorithm fairness and explainability.Summary: Future privacy protection for ophthalmic patients still faces challenges and requires improved strategies. Progress in privacy protection technology for ophthalmology will continue to promote a better healthcare environment and patient experience, as well as more effective data sharing and scientific research.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"431-437"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immune recovery uveitis: an ocular manifestation in HIV/AIDS receiving treatment. 免疫恢复性葡萄膜炎：接受治疗的艾滋病毒/艾滋病患者的一种眼部表现。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-07-16 DOI: 10.1097/ICU.0000000000001078

Martin M Dionson

{"title":"Immune recovery uveitis: an ocular manifestation in HIV/AIDS receiving treatment.","authors":"Martin M Dionson","doi":"10.1097/ICU.0000000000001078","DOIUrl":"10.1097/ICU.0000000000001078","url":null,"abstract":"Purpose of review: This article intends to briefly discuss AIDS, summarize the current literature on immune recovery uveitis, describe its ocular manifestations and complications, and tackle its complex management.Recent findings: The clinical picture of immune recovery uveitis is still evolving. Up to today, there are still no definite criteria for immune recovery uveitis, and although closely associated with cytomegalovirus retinitis and HIV/AIDS, there are several cases of similar intraocular response in non-HIV patients. The exact pathology for this paradoxical inflammatory reaction remains unclear; however, there is an interest in identifying biomarkers to determine underlying mechanisms and identify patients at risk. The management of this disease also remains a challenge and no standardized treatment approach exists currently.Summary: Immune recovery uveitis is an important cause of visual morbidity particularly in HIV/AIDS patients receiving highly active antiretroviral. It is a paradoxical reaction that is frequently associated with a prior cytomegalovirus retinitis infection. Although it can be a transient and self-limiting process, there is a complex decision on the timing of antiviral treatment and the initiation of antiretroviral treatment to prevent immune recovery uveitis. Furthermore, a substantial challenge arises in balancingtreatment decisions for complications in refractory cases.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"507-512"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vision language models in ophthalmology. 眼科视觉语言模型。

IF 3 2区医学

Current Opinion in Ophthalmology Pub Date : 2024-11-01 Epub Date: 2024-08-26 DOI: 10.1097/ICU.0000000000001089

Gilbert Lim, Kabilan Elangovan, Liyuan Jin

{"title":"Vision language models in ophthalmology.","authors":"Gilbert Lim, Kabilan Elangovan, Liyuan Jin","doi":"10.1097/ICU.0000000000001089","DOIUrl":"10.1097/ICU.0000000000001089","url":null,"abstract":"Purpose of review: Vision Language Models are an emerging paradigm in artificial intelligence that offers the potential to natively analyze both image and textual data simultaneously, within a single model. The fusion of these two modalities is of particular relevance to ophthalmology, which has historically involved specialized imaging techniques such as angiography, optical coherence tomography, and fundus photography, while also interfacing with electronic health records that include free text descriptions. This review then surveys the fast-evolving field of Vision Language Models as they apply to current ophthalmologic research and practice.Recent findings: Although models incorporating both image and text data have a long provenance in ophthalmology, effective multimodal Vision Language Models are a recent development exploiting advances in technologies such as transformer and autoencoder models.Summary: Vision Language Models offer the potential to assist and streamline the existing clinical workflow in ophthalmology, whether previsit, during, or post-visit. There are, however, also important challenges to be overcome, particularly regarding patient privacy and explainability of model recommendations.","PeriodicalId":50604,"journal":{"name":"Current Opinion in Ophthalmology","volume":" ","pages":"487-493"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0