The Open Ophthalmology Journal最新文献

{"title":"Intravitreal Anti Vascular Endothelial Growth Factor Agents in The Management of Retinal Diseases: An Audit.","authors":"Bassey Fiebai,&nbsp;Victor Odogu","doi":"10.2174/1874364101711010315","DOIUrl":"https://doi.org/10.2174/1874364101711010315","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to describe our initial experience with the use of anti vascular endothelial growth factors (anti-VEGFs) in the treatment of retinal diseases.</p><p><strong>Methods: </strong>The case records of all patients who had received at least 3 doses of intravitreal anti- VEGF injections between January 2012 to December 2016 were reviewed. Information culled from the data was age, sex, indications for treatment, type of injection, presenting visual acuity, post injection visual acuity, systemic and ocular co morbidities. Results were analyzed using Statistical Package for Social Sciences (SPSS) 20.0 for Windows statistical software.</p><p><strong>Results: </strong>A total of 190 injections were given during the study period, to 58 eyes of 50 patients. Twenty-eight females (56.00%) and twenty-two males (44.00%) were seen with a mean age of 59.6± 11.66. Bevacizumab was the most frequently administered anti- VEGF, 142 (74.74%) while only 48(25.26%) injections of Ranibizumab were given. Three eyes had both bevacizumab and ranibizumab (1.58%). Retinal vein occlusion 61(32.11%) was the commonest indication for the injections followed by diabetic macular edema 43(22.63%) and proliferative diabetic retinopathy 42(22.11%). Others were neovascular age related macular degeneration, neovascular glaucoma, vitreous hemorrhage, myopic choroidal neovascularization and cystoid macular edema. There was an association between age and disease, (p = 0.001). There was an improvement in visual acuity after intervention in cases with retinal vein occlusion and diabetic macular edema, and this was statistically significant. Hypertension was the commonest systemic disorder in this series 81(42.36%) and the supero-temporal quadrant 131(68.95%) was the most preferred position to administer the injection. Floaters was the commonest complication seen.</p><p><strong>Conclusion: </strong>Anti VEGFs have become an invaluable tool in the management of a number of retinal diseases in our center. However, the cost implications are a hindrance to an increased uptake of this form of treatment. Cheaper alternative preparations should be made available to encourage the uptake. Government in developing countries should be encouraged to bear the health burden of the old aged pensioner (OAP).</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"315-321"},"PeriodicalIF":0.3,"publicationDate":"2017-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874364101711010315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35707147","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":"A Single Drop in the Eye - Effects on the Whole Body?","authors":"Anu Vaajanen,&nbsp;Heikki Vapaatalo","doi":"10.2174/1874364101711010305","DOIUrl":"https://doi.org/10.2174/1874364101711010305","url":null,"abstract":"<p><strong>Introduction: </strong>Although the local adverse effects of ophthalmic drugs, including allergic reactions, are well recognized, less is known about the systemic side- effects of eye drops, especially during pregnancy, breast-feeding and early childhood. Ophthalmologists should also be aware of unusual, in some cases even life-threatening, effects of commonly used eye drops.</p><p><strong>Conclusion: </strong>This brief review outlines the routes of systemic absorption and the kinetics of active components present in eye drops, and identifies the clinically relevant systemic adverse effects.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"305-314"},"PeriodicalIF":0.3,"publicationDate":"2017-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35706143","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 Chemotherapy-Induced Optic Neuropathy and Maculopathy: A Case Report.","authors":"David J Mathew,&nbsp;Anupriya Arthur,&nbsp;Sheeja Susan John","doi":"10.2174/1874364101711010298","DOIUrl":"https://doi.org/10.2174/1874364101711010298","url":null,"abstract":"<p><strong>Purpose: </strong>With the advent of more aggressive cytotoxic chemotherapy regimens, the incidence of ocular toxicity due to these drugs is also on the rise. We report a case of Presumed Chemotherapy-Induced optic neuropathy and maculopathy secondary to treatment with cytarabine and daunorubicin for Acute Myeloid Leukaemia (AML).</p><p><strong>Case report: </strong>A 50-year-old man with AML developed sudden decrease in vision in his left eye after three cycles of chemotherapy with cytarabine and daunorubicin. He presented to us six weeks later with bilateral optic atrophy and foveal atrophic changes with early bull's eye maculopathy. A diagnosis of presumed chemotherapy-induced optic neuropathy with maculopathy was made, and the patient was put on an alternative chemotherapeutic regimen. There was no further decrease in vision on follow up.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first report of clinically demonstrable macular toxicity in the form of macular atrophic changes and bull's eye maculopathy associated with the use of cytarabine and daunorubicin. Early diagnosis and appropriate management of such cases is imperative to prevent further visual deterioration.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"298-304"},"PeriodicalIF":0.3,"publicationDate":"2017-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35706142","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":"Ocular Signs Related to Overweight and Arterial Hypertension in Children: A Systematic Review.","authors":"Daniela S Schuh,&nbsp;Ângela B Piccoli,&nbsp;Raquel L Paiani,&nbsp;Cristiane R Maciel,&nbsp;Lucia C Pellanda,&nbsp;Manuel Ap Vilela","doi":"10.2174/1874364101711010273","DOIUrl":"https://doi.org/10.2174/1874364101711010273","url":null,"abstract":"<p><strong>Background: </strong>The ocular effects of obesity and hypertension need to be established and can be used as prognostic markers.</p><p><strong>Objective: </strong>To estimate the prevalence of ophthalmological alterations in children and adolescents who are overweight and/or have SAH.</p><p><strong>Methods: </strong>The database for this study included all observational studies (CS, cohort, case-control and \"baseline\" description of randomized clinical trials) with children and/or adolescents who were overweight, obese or had SAH and that measured ophthalmological alterations.</p><p><strong>Results: </strong>Comparative studies with healthy children demonstrated positive association between body adiposity with retinal venular dilation, and SAH with retinal arteriolar narrowing. Different retinal fundus cameras and computer-assisted programs to evaluate the retinal vessels, variations in the methods of analysis, adjustments, populations, were the main arguments against formal meta-analysis. The heterogeneity was too high (I² >90%, in fixed or randomized effects), and the lack of linearity, normal distribution and homoscedasticity did not recommend meta-regression.</p><p><strong>Conclusion: </strong>Obesity and SAH show associations with ophthalmological alterations, especially with retinal vessel diameter. Lack of standardization does not allow a quantitative evaluation.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"273-285"},"PeriodicalIF":0.3,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35552964","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":"Comparison of Polypropylene Sling with Combined Transconjunctival Retractor Plication and Lateral Tarsal Strip for Correction of Involutional Lower Eye Lid Ectropion.","authors":"Ruchi Goel,&nbsp;Abhilasha Sanoria,&nbsp;Sushil Kumar,&nbsp;Deepanjali Arya,&nbsp;Smriti Nagpal,&nbsp;Neha Rathie","doi":"10.2174/1874364101711010285","DOIUrl":"https://doi.org/10.2174/1874364101711010285","url":null,"abstract":"<p><strong>Purpose: </strong>The study aims to compare the effectiveness and complications of transconjunctival retractor plication (TRP) with lateral tarsal strip (LTS) and the polypropylene sling (PS) surgery for treatment of involutional lower lid ectropion.</p><p><strong>Method: </strong>A prospective randomised pilot study was conducted on 30 eyes of 30 patients suffering from epiphora having horizontal eyelid laxity >6mm and age >50 years at a tertiary care centre from December 2014 to March 2015. They were randomly divided into two equal groups for TRP with LTS (group A) and PS (group B). Success was defined as relief in epiphora and lid laxity ≤4mm at 12 months post operatively.</p><p><strong>Result: </strong>There were 19 male and 11 female patients with age ranging from 55-80 years. The mean grade of ectropion was 2.80±1.32 in group A and 2.87±1.60 in group B. The preoperative horizontal laxity increased with the grade of ectropion (p <0.001) while medial canthal laxity was variable. The average surgical time per procedure in group A was 66 minutes and in group B was 24 minutes. Group A had a success rate of 93.33%, while group B had a success rate of 87%. Post-operative complications occurred in 2 eyes in group B only.</p><p><strong>Conclusion: </strong>Both LTS with TRP and PS are effective in the management of involutional ectropion. LTS with TRP though more invasive has higher success rates and a lower incidence of complications as compared to PS. However, PS is an easy to perform out- patient procedure that is faster and better tolerated in old patients.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"285-297"},"PeriodicalIF":0.3,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35552965","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":"Conventional Versus Accelerated Collagen Cross-Linking for Keratoconus: A Comparison of Visual, Refractive, Topographic and Biomechanical Outcomes.","authors":"Jyh Haur Woo,&nbsp;Jayant Venkatramani Iyer,&nbsp;Li Lim,&nbsp;M Htoon Hla,&nbsp;Jodhbir S Mehta,&nbsp;Cordelia Ml Chan,&nbsp;Donald Th Tan","doi":"10.2174/1874364101711010262","DOIUrl":"https://doi.org/10.2174/1874364101711010262","url":null,"abstract":"<p><strong>Objective: </strong>The aim was to compare the visual, refractive, topographic and biomechanical outcomes in patients with progressive keratoconus treated with either conventional or accelerated crosslinking at one year follow up.</p><p><strong>Methods: </strong>It is a prospective, non-randomised interventional study of 76 patients who underwent conventional (CXL; 3mW/cm² for 30 minutes) or accelerated cross linking (KXL; 30mW/cm² for 4 minutes) for progressive keratoconus. Baseline and postoperative visual acuity, manifest refraction, corneal topography, pachymetry, endothelial cell density and biomechanical parameters of corneal hysteresis and corneal resistance factor were evaluated and compared.</p><p><strong>Results: </strong>The 2 groups were comparable in terms of uncorrected and best corrected visual acuity and spherical equivalent. Both groups showed no significant increase in K1, K2 and Kmean from baseline at 12 months. There was also no difference between the CXL and KXL group for postoperative corneal topography as well as central and minimal pachymetry up to 12 months. There was a significant increase in both corneal hysteresis (0.62mm Hg, P=0.04) and corneal resistance factor (0.91mm Hg, P=0.003) in the KXL group at 12 months but not in the CXL group. There was no significant endothelial cell loss throughout follow up in both the groups.</p><p><strong>Conclusion: </strong>We have established comparability of the 2 protocols in stabilizing the progression of keratoconus. Our findings also suggested an added biomechanical advantage of accelerated crosslinking at 1 year follow up.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"262-272"},"PeriodicalIF":0.3,"publicationDate":"2017-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874364101711010262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35552963","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":"Editorial: Keratoconus - What We Do Not Know.","authors":"Zisis Gatzioufas,&nbsp;Samer Hamada,&nbsp;Damian Lake,&nbsp;Berthold Seitz","doi":"10.2174/1874364101711010173","DOIUrl":"https://doi.org/10.2174/1874364101711010173","url":null,"abstract":"Keratoconus has been recognized and investigated for more than 150 years [1]. Especially over the last decades, there has been intensive translational and clinical research in the field of corneal ectatic diseases, thereby revolutionizing the diagnosis and management of keratoconus. However, despite fundamental advances in understanding the complexity of this entity, the true nature of keratoconus remains merely unknown.","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"173-175"},"PeriodicalIF":0.3,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35428823","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":"Recent Innovations in Collagen Corneal Cross-linking; a Mini Review.","authors":"Iraklis Vastardis,&nbsp;Brigitte Pajic-Eggspuehler,&nbsp;Charis Nichorlis,&nbsp;Jörg Mueller,&nbsp;Bojan Pajic","doi":"10.2174/1874364101711010217","DOIUrl":"https://doi.org/10.2174/1874364101711010217","url":null,"abstract":"<p><strong>Background: </strong>The introduction of corneal cross-linking (CXL) with ultraviolet-A (UVA) and Riboflavin photosensitizer (Vit B₂) from Seiler <i>et al.</i>, revolutionized the treatment of Keratoconus and other corneal ectatic diseases. Today, the commonly known epithelium off Dresden protocol is in clinical use for the last 15 years with great success and regarded by many as the golden standard.</p><p><strong>Methods: </strong>With several studies demonstrating its simplicity, efficacy and safety this revolutionary method, paved the way for new therapies and strategies in the treatment of corneal ectatic diseases and changed our understanding in corneal biomechanics. Recent scientific and technological advances enabled the creation of various modifications of the initial CXL protocol and the formation of new ones.</p><p><strong>Conclusion: </strong>This work highlights the recent advances of CXL, such as the role of oxygen, higher fluence and shorter irradiation times as well as the various clinical applications and updates of this method.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"217-224"},"PeriodicalIF":0.3,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35531459","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":"Penetrating Keratoplasty for Keratoconus - Excimer Versus Femtosecond Laser Trephination.","authors":"Berthold Seitz,&nbsp;Achim Langenbucher,&nbsp;Tobias Hager,&nbsp;Edgar Janunts,&nbsp;Moatasem El-Husseiny,&nbsp;Nora Szentmáry","doi":"10.2174/1874364101711010225","DOIUrl":"https://doi.org/10.2174/1874364101711010225","url":null,"abstract":"<p><strong>Background: </strong>In case of keratoconus, rigid gas-permeable contact lenses as the correction method of first choice allow for a good visual acuity for quite some time. In a severe stage of the disease with major cone-shaped protrusion of the cornea, even specially designed keratoconus contact lenses are no more tolerated. In case of existing contraindications for intrastromal ring segments, corneal transplantation typically has a very good prognosis.</p><p><strong>Methods: </strong>In case of advanced keratoconus - especially after corneal hydrops due to rupture of Descemet's membrane - penetrating keratoplasty (PKP) still is the surgical method of first choice. Noncontact excimer laser trephination seems to be especially beneficial for eyes with iatrogenic keratectasia after LASIK and those with repeat grafts in case of \"keratoconus recurrences\" due to small grafts with thin host cornea. For donor trephination from the epithelial side, an artificial chamber is used. Wound closure is achieved with a double running cross-stitch suture according to Hoffmann. Graft size is adapted individually depending on corneal size (\"as large as possible - as small as necessary\"). Limbal centration will be preferred intraoperatively due to optical displacement of the pupil. During the last 10 years femtosecond laser trephination has been introduced from the USA as a potentially advantageous approach.</p><p><strong>Results: </strong>Prospective clinical studies have shown that the technique of non-contact excimer laser PKP improves donor and recipient centration, reduces \"vertical tilt\" and \"horizontal torsion\" of the graft in the recipient bed, thus resulting in significantly less \"all-sutures-out\" keratometric astigmatism (2.8 vs. 5.7 D), higher regularity of the topography (SRI 0.80 vs. 0.98) and better visual acuity (0.80 vs. 0.63) in contrast to the motor trephine. The stage of the disease does not influence functional outcome after excimer laser PKP. Refractive outcomes of femtosecond laser keratoplasty, however, resemble that of the motor trephine.</p><p><strong>Conclusions: </strong>In contrast to the undisputed clinical advantages of excimer laser keratoplasty with orientation teeth/notches in keratoconus, the major disadvantage of femtosecond laser application is still the necessity of suction and applanation of the cone during trephination with intraoperative pitfalls and high postoperative astigmatism.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"225-240"},"PeriodicalIF":0.3,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874364101711010225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35531460","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":"Pathophysiology of Keratoconus: What Do We Know Today.","authors":"Uri Soiberman,&nbsp;James W Foster,&nbsp;Albert S Jun,&nbsp;Shukti Chakravarti","doi":"10.2174/1874364101711010252","DOIUrl":"https://doi.org/10.2174/1874364101711010252","url":null,"abstract":"<p><p>Keratoconus is a common corneal ectasia that leads to progressive visual impairment. Numerous studies have shown abnormal protein expression patterns in keratoconic corneas. However, the specific mechanisms causing this disease remain ambiguous. This review aims to provide an update on morphological studies of the keratoconic cornea, relate these early studies with current findings from proteomic, biochemical and cell culture studies and to postulate possible pathogenic pathways.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"252-261"},"PeriodicalIF":0.3,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874364101711010252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35531463","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}