The Open Ophthalmology Journal最新文献

{"title":"Cataract Surgery in Patients with Keratoconus: Pearls and Pitfalls.","authors":"F Aiello,&nbsp;Q J Nasser,&nbsp;C Nucci,&nbsp;R I Angunawela,&nbsp;Z Gatzioufas,&nbsp;V Maurino","doi":"10.2174/1874364101711010194","DOIUrl":"https://doi.org/10.2174/1874364101711010194","url":null,"abstract":"<p><strong>Background: </strong>Keratoconus (KC) is a common ectatic disorder resulting in progressive corneal thinning and irregular astigmatism. It has been observed that patients affected by KC are more likely to develop lens opacities earlier compared to non-keratoconic patients.</p><p><strong>Objective: </strong>Intraocular lens (IOL) selection and refractive outcome prediction are among a number of factors that can make cataract surgery in keratoconic patients challenging. Accurate biometry is often difficult to obtain due to unreliable K measurements and lack of dedicated biometric formulae. The use of toric IOLs has also been investigated.</p><p><strong>Conclusions: </strong>Determining the stage of KC, pre-operative patient counselling and the preferred method of refractive correction are all crucial to obtain successful postoperative outcomes and good patient satisfaction. The use of toric IOLs can achieve good results only in selected low-grade keratoconic eyes.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"194-200"},"PeriodicalIF":0.3,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874364101711010194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35428825","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":"Genetics in Keratoconus - What is New?","authors":"Sarah Moussa,&nbsp;Günther Grabner,&nbsp;Josef Ruckhofer,&nbsp;Marie Dietrich,&nbsp;Herbert Reitsamer","doi":"10.2174/1874364101711010201","DOIUrl":"https://doi.org/10.2174/1874364101711010201","url":null,"abstract":"<p><strong>Background: </strong>Keratoconus is characterized as a bilateral, progressive, non-inflammatory thinning of the cornea resulting in blurred vision due to irregular astigmatism. Keratoconus has a multifactorial etiology, with multiple genetic and environmental components contributing to the disease pathophysiology. Several genomic loci and genes have been identified that highlight the complex molecular etiology of this disease.</p><p><strong>Conclusion: </strong>The review focuses on current knowledge of these genetic risk factors associated with keratoconus.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"201-210"},"PeriodicalIF":0.3,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35428826","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":"Contact Lenses for Keratoconus- Current Practice.","authors":"Marilita M Moschos,&nbsp;Eirini Nitoda,&nbsp;Panagiotis Georgoudis,&nbsp;Miltos Balidis,&nbsp;Eleftherios Karageorgiadis,&nbsp;Nikos Kozeis","doi":"10.2174/1874364101711010241","DOIUrl":"https://doi.org/10.2174/1874364101711010241","url":null,"abstract":"<p><strong>Background: </strong>Keratoconus is a chronic, bilateral, usuallly asymmetrical, non-inflammatory, ectatic disorder, being characterized by progressive steepening, thinning and apical scarring of the cornea. Initially, the patient is asymptomatic, but the visual acuity gradually decreases, resulting in significant vision loss due to the development of irregular astigmatism, myopia, corneal thinning and scarring. The classic treatment of visual rehabilitation in keratoconus is based on spectacles and contact lenses (CLs).</p><p><strong>Objective: </strong>To summarize the types of CLs used in the treatment of keratoconus. This is literature review of several important published articles focusing on the visual rehabilitation in keratoconus with CLs.</p><p><strong>Method: </strong>Gas permeable (GP) CLs have been found to achieve better best corrected visual acuity than spectacles, eliminating 3rd-order coma root-mean-square (RMS) error, 3rd-order RMS, and higher-order RMS. However, they have implicated in reduction of corneal basal epithelial cell and anterior stromal keratocyte densities. Soft CLs seem to provide greater comfort and lower cost, but the low oxygen permeability (if the lens is not a silicone hydrogel), and the inability to mask moderate to severe irregular astigmatism are the main disadvantages of them. On the other hand, scleral CLs ensure stable platforms, which eliminate high-order aberrations and provide good centration and visual acuity. Their main disadvantages include the difficulties in application and removal of these lenses along with corneal flattening and swelling.</p><p><strong>Result: </strong>The modern hybrid CLs are indicated in cases of poor centration, poor stability or intolerance with GP lenses. Finally, piggyback CL systems effectively ameliorate visual acuity, but they have been related to corneal neovascularization and giant papillary conjunctivitis.</p><p><strong>Conclusion: </strong>CLs seem to rehabilitate visual performance, diminishing the power of the cylinder and the high-order aberrations. The final choice of CLs is based on their special features, the subsequent corneal changes and the patient's needs.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"241-251"},"PeriodicalIF":0.3,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874364101711010241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35531461","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":"Collagen Cross- Linking for Paediatric Keratoconus.","authors":"Georgios D Panos,&nbsp;Nikolaos Kozeis,&nbsp;Miltiadis Balidis,&nbsp;Marilita M Moschos,&nbsp;Farhad Hafezi","doi":"10.2174/1874364101711010211","DOIUrl":"https://doi.org/10.2174/1874364101711010211","url":null,"abstract":"<p><strong>Background: </strong>Since the late 1990s corneal crosslinking (CXL) has been proposed as a new treatment option which can stop progression of keratoconus with promising results in adults.</p><p><strong>Objective: </strong>Keratoconus presents a higher rate and faster progression in paediatric patients and for this reason prompt and effective treatment is essential. Due to its success in adult keratoconus patients, CXL has been recently applied to children in order to stop or slow progression of keratoconus in paediatric patients.</p><p><strong>Conclusions: </strong>This article will present an update of the literature on the topic of CXL in this age group.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"211-216"},"PeriodicalIF":0.3,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35531458","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":"Combined Intravitreal Dexamethasone Implant And Micropulse Yellow Laser For Treatment Of Anti-VEGF Resistant Diabetic Macular Edema.","authors":"Ahmed Hosni Abd Elhamid","doi":"10.2174/1874364101711010164","DOIUrl":"https://doi.org/10.2174/1874364101711010164","url":null,"abstract":"<p><strong>Purpose: </strong>To report the efficacy and safety of combined intravitreal dexamethasone implant and micropulse laser for anti-VEGF resistant diabetic macular edema.</p><p><strong>Patients and methods: </strong>Prospective, non-controlled study that was conducted for twenty eyes with center-involved diabetic macular edema not responding to anti-VEGF therapy. Ozurdex intravitreal implant was injected to all eyes with subsequent micropulse yellow laser one month after the injection. All eyes were followed up after one, three, four, six, nine and twelve months. The primary outcome measure is the change in best corrected visual acuity (BCVA) after one year and secondary outcome measures are central macular thickness (CMT) change and safety of both dexamethasone implant and micropulse laser. Reinjection was done for those eyes with recurrent edema.</p><p><strong>Results: </strong>The mean age was 58.8 ±7.94 years. The mean BCVA was 0.6± 0.14, 0.57 ±0.12, 0.51±0.15, 0.59±0.12, 0.6± 0.12 and 0.59±0.14 after one, three, four, six, nine and twelve months in comparison to 0.45± 0.14 as initial BCVA [SS,P<0.05]. The CMT was 302.5±30.01, 330.6±20.24, 357.6±32.15, 285.4±19.95, 292.9±25.07 and 285.2±14.99 after one ,three, four ,six , nine and twelve months µm in comparison to initial CMT of 420.7 ±38.74µm [HS, P<0.01]. Cataract occurred in 6 eyes from 14 phakic eyes (42.8%). Transient ocular hypertension occurred in 6 eyes (30%). Reinjection was done for eight eyes (40%).</p><p><strong>Conclusion: </strong>Intravitreal dexamethasone implant and micropulse laser are both effective and safe treatment options for anti-VEGF resistant diabetic macular edema.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"164-172"},"PeriodicalIF":0.3,"publicationDate":"2017-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5543696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35344396","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":"The Effects of Ramadan Fasting on Anterior Segment Parameters, Visual Acuity and Intraocular Pressures of the Eye.","authors":"Ozlem Barut Selver,&nbsp;Melis Palamar,&nbsp;Kevser Gerceker,&nbsp;Sait Egrilmez,&nbsp;Ayse Yagci","doi":"10.2174/1874364101711010152","DOIUrl":"https://doi.org/10.2174/1874364101711010152","url":null,"abstract":"<p><strong>Objective: </strong>It is aimed to determine whether fasting during Ramadan has any significant effect on anterior chamber parameters, visual acuity and intraocular pressures.</p><p><strong>Methods: </strong>31 fasting (Group 1) and 30 non-fasting healthy volunteers (Group 2) were enrolled. All cases underwent an ophthalmological examination and anterior segment parameter evaluation (central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), pupil size) with Pentacam before and after the breaking of the Ramadan fast in Group 1, before and after dinner in Group 2.</p><p><strong>Results: </strong>The mean age was 43.35 ± 13.20 in Group 1, 43.17 ± 12.90 in Group 2 (p= 0.955). No significant difference was detected in any of the parameters in both groups.</p><p><strong>Conclusion: </strong>There is a need for more detailed and associated studies to understand better about the influence of Ramadan fast on various ocular parameters.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"152-155"},"PeriodicalIF":0.3,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35278550","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":"Efficacy and Safety of Switching from Prostaglandin Analog Therapy to Prostaglandin / Timolol Fixed Combination or Prostaglandin / Brimonidine Therapy.","authors":"Kenji Inoue,&nbsp;Mieko Masumoto,&nbsp;Kyoko Ishida,&nbsp;Goji Tomita","doi":"10.2174/1874364101711010156","DOIUrl":"https://doi.org/10.2174/1874364101711010156","url":null,"abstract":"<p><strong>Background: </strong>To compare the safety and efficacy between switching to prostaglandin/timolol fixed combination eye drops (PG/timolol FCs) and adding brimonidine to PG analogue monotherapy.</p><p><strong>Methods: </strong>Eyes of 53 patients with primary open-angle glaucoma or ocular hypertension who were receiving PG analogue monotherapy were included. Participants were randomly divided into two treatment groups: one was prescribed PG/timolol FCs (switched group), and for the other, 0.1% brimonidine was added to the PG analogue (added group). Intraocular pressure (IOP), blood pressure, and pulse rate were measured after 1 and 3 months and compared to baseline values. Participants were also surveyed to determine if they had experienced systemic or topical adverse events at each study visit. IOP changes at 1 and 3 months were compared between groups.</p><p><strong>Results: </strong>Three months after changing medication, mean IOP was 14.6 ± 2.4 mmHg in the switched group and 13.7 ± 1.8 mmHg in the added group; both were significantly lower than the baseline values (switched group, 16.5 ± 2.7 mmHg; added group, 15.8 ± 2.3 mmHg; both P < 0.001). Neither the mean nor the percentage reductions in IOP were significantly different between groups at 1 and 3 months. In the added group, diastolic blood pressure was lower than that at 1 and 3 months, systolic blood was lower than that at 3 months (P < 0.01). The patients who had experienced systemic or topical adverse events were 53.8% in the added group and 40.7% in the the changed group, which was equivalent between groups (P =0.4142). Three patients (11.5%) in the added group, but none from the switched group, were excluded from analyses because of adverse events (not significant, P = 0.217).</p><p><strong>Conclusion: </strong>Switching from a PG analogue to PG/timolol FCs or to PG with brimonidine was equally safe (systemically and topically) and effective in reducing IOP. Thus, PG with brimonidine might be appropriate medication in patients who cannot use PG/timolol FCs due to repiratory or circulatory disease.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"156-163"},"PeriodicalIF":0.3,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874364101711010156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35278551","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":"Using an Image Fusion Methodology to Improve Efficiency and Traceability of Posterior Pole Vessel Analysis by ROPtool.","authors":"Sasapin G Prakalapakorn,&nbsp;Laura A Vickers,&nbsp;Rolando Estrada,&nbsp;Sharon F Freedman,&nbsp;Carlo Tomasi,&nbsp;Sina Farsiu,&nbsp;David K Wallace","doi":"10.2174/1874364101711010143","DOIUrl":"https://doi.org/10.2174/1874364101711010143","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of plus disease in retinopathy of prematurity (ROP) largely determines the need for treatment; however, this diagnosis is subjective. To make the diagnosis of plus disease more objective, semi-automated computer programs (<i>e.g.</i> ROPtool) have been created to quantify vascular dilation and tortuosity. ROPtool can accurately analyze blood vessels only in images with very good quality, but many still images captured by indirect ophthalmoscopy have insufficient image quality for ROPtool analysis.</p><p><strong>Purpose: </strong>To evaluate the ability of an image fusion methodology (robust mosaicing) to increase the efficiency and traceability of posterior pole vessel analysis by ROPtool.</p><p><strong>Materials and methodology: </strong>We retrospectively reviewed video indirect ophthalmoscopy images acquired during routine ROP examinations and selected the best unenhanced still image from the video for each infant. Robust mosaicing was used to create an enhanced mosaic image from the same video for each eye. We evaluated the time required for ROPtool analysis as well as ROPtool's ability to analyze vessels in enhanced vs. unenhanced images.</p><p><strong>Results: </strong>We included 39 eyes of 39 infants. ROPtool analysis was faster (125 vs. 152 seconds; <i>p</i>=0.02) in enhanced vs. unenhanced images, respectively. ROPtool was able to trace retinal vessels in more quadrants (143/156, 92% vs 115/156, 74%; p=0.16) in enhanced mosaic vs. unenhanced still images, respectively and in more overall (38/39, 97% vs. 34/39, 87%; p=0.07) enhanced mosaic vs. unenhanced still images, respectively.</p><p><strong>Conclusion: </strong>Retinal image enhancement using robust mosaicing advances efforts to automate grading of posterior pole disease in ROP.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"143-151"},"PeriodicalIF":0.3,"publicationDate":"2017-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35278549","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":"Many Faces of Renin-angiotensin System - Focus on Eye.","authors":"Mervi Holappa,&nbsp;Heikki Vapaatalo,&nbsp;Anu Vaajanen","doi":"10.2174/1874364101711010122","DOIUrl":"https://doi.org/10.2174/1874364101711010122","url":null,"abstract":"<p><p>The renin-angiotensin system (RAS), that is known for its role in the regulation of blood pressure as well as in fluid and electrolyte homeostasis, comprises dozens of angiotensin peptides and peptidases and at least six receptors. Six central components constitute the two main axes of the RAS cascade. Angiotensin (1-7), an angiotensin converting enzyme 2 and Mas receptor axis (ACE2-Ang(1-7)-MasR) counterbalances the harmful effects of the angiotensin II, angiotensin converting enzyme 1 and angiotensin II type 1 receptor axis (ACE1-AngII-AT1R) Whereas systemic RAS is an important factor in blood pressure regulation, tissue-specific regulatory system, responsible for long term regional changes, that has been found in various organs. In other words, RAS is not only endocrine but also complicated autocrine system. The human eye has its own intraocular RAS that is present <i>e.g.</i> in the structures involved in aqueous humor dynamics. Local RAS may thus be a target in the development of new anti-glaucomatous drugs. In this review, we first describe the systemic RAS cascade and then the local ocular RAS especially in the anterior part of the eye.</p>","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"122-142"},"PeriodicalIF":0.3,"publicationDate":"2017-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35278481","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":"First Reported Case of Donor Related Candida Endophthalmitis after Descemet Membrane Endothelial Keratoplasty.","authors":"Matthew Thompson,&nbsp;David Carli","doi":"10.2174/1874364101711010117","DOIUrl":"https://doi.org/10.2174/1874364101711010117","url":null,"abstract":"Purpose: To report the first case of Candida donor to host transmission following descemet membrane endothelial keratoplasty (DMEK) Methods: A retrospective case report. Results: A patient underwent uneventful DMEK. Following surgery the donor rim was culture positive for Candida. The patient developed fungal endophthalmitis that was treated medically with multiple injections of voriconazole and amphotericin. Medical treatment was unable to clear the infection and removal of the donor material was required. Following removal the infection subsided. Conclusion: Candida interface keratitis and endophthalmitis can occur following DMEK and may be difficult to treat medically. Early removal of the donor material should be considered.","PeriodicalId":512318,"journal":{"name":"The Open Ophthalmology Journal","volume":"11 ","pages":"117-121"},"PeriodicalIF":0.3,"publicationDate":"2017-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35278548","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}