Clinical and Experimental Ophthalmology最新文献

{"title":"Continuing Professional Development","authors":"","doi":"10.1111/ceo.14458","DOIUrl":"10.1111/ceo.14458","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"52 8","pages":"897-899"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633134","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}

{"title":"Bringing Mohammad to the mountain: New strategies for intravitreal therapy service delivery","authors":"Fred K. Chen PhD, FRANZCO, Rachael C. Heath Jeffery MPH, MChD, Adrian T. Fung MMed, FRANZCO","doi":"10.1111/ceo.14457","DOIUrl":"10.1111/ceo.14457","url":null,"abstract":"<p>Intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents is a well-established therapeutic option for neovascular age-related macular degeneration (nAMD),<span><sup>1</sup></span> diabetic macular oedema (DMO)<span><sup>2</sup></span> and retinal vein occlusion (RVO).<span><sup>3</sup></span> The number of Medicare claims for intravitreal injections (item#42738) has increased from 181 140 to 621 001 per annum from 2012 to 2022; the equivalent of 8–24 injections per 1000 population-year.<span><sup>4</sup></span> This is increase is due to, in part, the expanding indications and improved patient access. With the rapidly growing demand, advances in treatments and models of care are essential to provide sufficient service delivery to patients requiring intravitreal therapy (IVT). Broadly, the considerations of an IVT service can be divided into pharmacologic agents, treatment regimens, drug delivery, staffing, treatment setup and complications management.</p><p>Newer pharmacological agents show promise for increased durability. Faricimab (Vabysmo) allows treatment intervals of up to 16 weeks in around 60% of patients after 2 years of treatment for nAMD<span><sup>5</sup></span> and DMO.<span><sup>6</sup></span> Aflibercept 8 mg (Eylea HD) allows for maintenance of 16 week treatment intervals in 70% of nAMD patients and 84% of DMO patients after 2 years of treatment, with 28% of nAMD patients even meeting criteria for 24 week intervals. A direct comparison between these two agents cannot be made, as true head-to-head studies are yet to be conducted and the treatment and extension criteria for their pivotal phase III studies differed.</p><p>Monthly administration is not feasible nor necessary in all patients. Compared with fixed dosing, a treat-and-extend (T&E) regimen has been shown to reduce the treatment burden without compromising efficacy in patients requiring anti-VEGF agents for nAMD.<span><sup>7</sup></span> There is less consensus for treatment regimens in treating DMO, although a recent systematic review supports the use of T&E in this disease too.<span><sup>8</sup></span></p><p>The port delivery system (PDS) allows at least a six monthly refill-exchange,<span><sup>9</sup></span> but has a higher rate of endophthalmitis than intravitreal injections at around 2%,<span><sup>10</sup></span> and does not necessarily reduce visit burden as the device itself requires surveillance for local complications. Intraocular gene therapy (intravitreal, subretinal or suprachoroidal) holds the promise of lifelong treatment,<span><sup>11</sup></span> but this has been associated with up to a 21%–45% rate of vector-related uveitis.<span><sup>12</sup></span></p><p>Worldwide, the vast majority of intravitreal injections are still performed by ophthalmologists. Variances in this model are seen in some centres in the UK and Singapore, where nurses can administer intravitreal injections under ophthalmology supervision. Virtual AMD cl","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"52 8","pages":"797-799"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14457","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of and chorioretinal circulation during repeated low-level red-light therapy for myopic children","authors":"Zhaoxin Jiang MD, PhD,&nbsp;Shuyu Chen MD,&nbsp;Renchun Wang MD,&nbsp;Jin Ma MD, PhD","doi":"10.1111/ceo.14462","DOIUrl":"10.1111/ceo.14462","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To evaluate the safety of repeated low-level red-light (RLRL) therapy in children, and the dynamic evolution of choroidal and retinal blood flow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a single-centre, randomised, single-blind, parallel-group clinical trial. Seventy myopic children were randomly assigned to either the intervention group [receiving RLRL therapy plus single-vision spectacle (SVS)] or the control group (wearing SVS). Participants underwent comprehensive ophthalmic examinations following their first irradiation, 9 months continuous RLRL therapy and stop of treatment. Quantitative analyses of choroidal and retinal microcirculation were analysed via optical coherence tomography angiography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over 9 months of treatment, while the RLRL treatment demonstrated significantly less increases in refractive error and axial length compared with the SVS treatment (<i>p</i>s &lt; 0.05), no abnormalities in fundus structure or visual function (mfERG, VEP and microperimetry) were detected (<i>p</i>s &gt; 0.05). A single red-light exposure did not exert a significant influence on choroidal thickness (<i>p</i>s &gt; 0.05). Upon continuous treatment, the RLRL group achieved peak values in these circulations at 9 months (<i>p</i>s &lt; 0.05). Following cessation of exposure, all circulations exhibited a declining trend, reaching similar levels in both groups (<i>p</i>s &gt; 0.05). As the frequency of red-light exposures intensified, there was a consistent surge in these circulations (<i>p</i>s &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nine months of continuous RLRL exposure does not cause toxic side effects on retinal or optic nerve functions, and there is a time-dependent cumulative response in choroidal and retinal circulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 2","pages":"119-132"},"PeriodicalIF":4.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584941","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}

{"title":"Unnecessary duplication of human leukocyte antigen testing for uveitis in an Australian tertiary hospital","authors":"Mark B. Beecher,&nbsp;Carmelo Macri MBBS, MPhil,&nbsp;Pravin Hissaria MD, FRACP,&nbsp;Weng Onn Chan MPhil, FRANZCO","doi":"10.1111/ceo.14459","DOIUrl":"10.1111/ceo.14459","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 1","pages":"103-104"},"PeriodicalIF":4.9,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513295","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}

{"title":"Drug-associated glaucoma: A real-world study based on the Food and Drug Administration adverse event reporting system database","authors":"Shi-Nan Wu MD,&nbsp;Xiao-Dong Chen MD,&nbsp;Dan Yan PhD,&nbsp;Yu-Qian Wang PhD,&nbsp;Shao-Pan Wang PhD,&nbsp;Wen-Ying Guan PhD,&nbsp;Caihong Huang MD,&nbsp;Jiaoyue Hu MD, PhD,&nbsp;Zuguo Liu MD, PhD","doi":"10.1111/ceo.14454","DOIUrl":"10.1111/ceo.14454","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aims to assess the risk of drug-associated glaucoma and track its epidemiological characteristics using real-world data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adverse event reports from the Food and Drug Administration Adverse Event Reporting System (FAERS) from January 2004 to December 2023 were analysed. Disproportionality analysis and the Bayesian Confidence Propagation Neural Network algorithm were used. The study classified drugs associated with glaucoma, assessed risk levels, and compared drug-induced times across different categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight hundred and five drugs were linked to glaucoma in the FAERS database. Disproportionality analysis identified 46 drugs with significant risk, mainly adrenergic medications (clobetasol propionate, fluocinolone acetonide), antihypertensives (hydrochlorothiazide), insulin (insulin human), anticholinergics (umeclidinium, darifenacin), VEGF inhibitors (brolucizumab, faricimab), and psychotropics (topiramate, ziprasidone). The top three high-risk drugs were clobetasol propionate, umeclidinium, and fluocinolone acetonide. The shortest drug-induced times were observed with indacaterol, salmeterol, and umeclidinium. Anticholinergic medications had the shortest drug-induced time among all categories. Females (62.5%) and the elderly (average age 63.5 ± 16.8 years) were predominantly affected. Reports of drug-associated glaucoma increased over the years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preventing drug-associated glaucoma is more effective than treatment. Identifying the risk and drug-induced times of systemic and ophthalmic drugs can reduce occurrence risk. Clinical practitioners should be vigilant and inform patients of these risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 2","pages":"140-160"},"PeriodicalIF":4.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513293","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}

{"title":"Evaluation of moderate periorbital cellulitis and home-based therapy in children (EPOCH study, Part 2): A prospective single centre cohort study","authors":"Zachary McPherson PhD, MRCPCH,&nbsp;Deepali Thosar MClinEpi,&nbsp;Amie Donnelly HEDip (Nurs),&nbsp;Nadine Shaw BSN,&nbsp;Julia Starte MMed, FRANZCO,&nbsp;Michael Jones PhD, FRANZCO,&nbsp;Shefali Jani FRACP, MClinEpi","doi":"10.1111/ceo.14455","DOIUrl":"10.1111/ceo.14455","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Paediatric periorbital cellulitis, a common eye condition, typically requires inpatient admission for intravenous antibiotics due to concerns about orbital spread. This study aimed to assess the safety and effectiveness of ambulatory management for children with moderate periorbital cellulitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Over a 24-month period, we prospectively enrolled 84 children aged 1 to 16 years who presented with moderate periorbital cellulitis to the emergency department. Demographic and clinical data were collected. Following a guideline-based decision tree, eligible children received intravenous antibiotics and were discharged with a peripheral cannula for follow-up in ambulatory care and ophthalmology clinics. Descriptive statistics were used for data presentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 84 children, 62 (73.8%) were managed through the ambulatory care model. Within the category of moderate POC, those who were admitted to the hospital did not have higher CRP or White Cell counts and received IV antibiotics for the same length of time. The ambulatory care clinic provided a total of 132 daily doses of intravenous antibiotics. Two children treated on this pathway required inpatient admission due to clinical deterioration, one of whom required ophthalmic surgical intervention. There was no mortality or sight-threatening complications in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Implementing a directed ambulatory care pathway for children with moderate periorbital cellulitis proved to be an effective and safe management strategy. This approach reduces the strain on hospital bed occupancy while promoting community-based patient care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 2","pages":"184-193"},"PeriodicalIF":4.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513294","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}

{"title":"Comparison of intraocular pressure and anterior segment parameters in subjects with asymmetrical primary angle closure disease: Comment","authors":"Liang Guo MD,&nbsp;Na Wang MD,&nbsp;Lu Yang MD","doi":"10.1111/ceo.14452","DOIUrl":"10.1111/ceo.14452","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"52 9","pages":"1025-1026"},"PeriodicalIF":4.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481309","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}

{"title":"Evaluation of ChatGPT-4 responses to glaucoma patients' questions: Can artificial intelligence become a trusted advisor between doctor and patient?","authors":"Muzaffer Said Güler MD,&nbsp;Elif Ertan Baydemir MD","doi":"10.1111/ceo.14451","DOIUrl":"10.1111/ceo.14451","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"52 9","pages":"1016-1019"},"PeriodicalIF":4.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481311","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}

{"title":"Comparison of intraocular pressure and anterior segment parameters in subjects with asymmetrical primary angle closure disease: Response","authors":"Shayne S. Tan MBBS, MRCS(Ed),&nbsp;Tin A. Tun MBBS, PhD,&nbsp;Monisha E. Nongpiur MD, PhD","doi":"10.1111/ceo.14453","DOIUrl":"10.1111/ceo.14453","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"52 9","pages":"1026-1027"},"PeriodicalIF":4.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481310","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}

{"title":"Prediction of refraction error after toric lens implantation with biometric input data uncertainties and power labelling tolerances","authors":"Achim Langenbucher PhD,&nbsp;Nóra Szentmáry MD, PhD,&nbsp;Alan Cayless PhD,&nbsp;David Cooke MD, PhD,&nbsp;Peter Hoffmann MD,&nbsp;Jascha Wendelstein MD, PhD","doi":"10.1111/ceo.14449","DOIUrl":"10.1111/ceo.14449","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The purpose of this study was to simulate the impact of biometric measure uncertainties, lens equivalent and toric power labelling tolerances and axis alignment errors on the refractive outcome after cataract surgery with toric lens implantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective non-randomised cross sectional Monte-Carlo simulation study we evaluated a dataset containing 7458 LenStar 900 preoperative biometric measurements. The biometric uncertainties from literature, lens power labelling according to ISO 11979, and axis alignment tolerances of a modern toric lens (Hoya Vivinex) were taken to be normally distributed and used in a Monte-Carlo simulation with 100 000 samples per eye. The target variable was the defocus equivalent (DEQ) derived using the Castrop (DEQ_C) and the Haigis (DEQ_H) formulae.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean/median / 90% quantile DEQ_C was 0.22/0.21/0.36 D and DEQ_H was 0.20/0.19/0.32 D. Ignoring the variation in lens power labelling and toric axis alignment the respective DEQ_C was 0.20/0.19/0.32 D and DEQ_H was 0.18/0.17/0.29 D. DEQ_C and DEQ_H increased with shorter eyes, steeper corneas, equivalent lens power and highly with toric lens power.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>According to our simulation results, uncertainties in biometric measures, lens power labelling tolerances, and axis alignment errors are responsible for a significant part of the refraction prediction error after cataract surgery with toric lens implantation. Additional labelling of the exact equivalent and toric power on the lens package could be a step to improve postoperative results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"53 1","pages":"26-38"},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}