Current Ophthalmology Reports最新文献

Purpose of review: This paper provides a detailed overview of systemic carbonic anhydrase inhibitors (CAIs) and their application in managing ophthalmic conditions, including glaucoma, cystoid macular edema, and idiopathic intracranial hypertension. Despite their recognized clinical benefits, the potential for severe systemic adverse effects often discourages clinicians from prescribing these agents. By examining the pharmacology, pharmacokinetics, safety profile, and clinical indications of systemic CAIs, this review highlights strategies to mitigate treatment challenges, particularly in patients with comorbidities and complex medical backgrounds.

Recent findings: New insights into the diverse roles and distribution of carbonic anhydrase (CA) isozymes have expanded our understanding of both the mechanisms and clinical implications of systemic CAIs. In the eye, CA-II and CA-IV are key contributors to aqueous humor production and ocular blood flow modulation, with dose-dependent improvements in choroidal perfusion observed upon enzyme inhibition. Beyond mechanism of action, tissue-bound drug concentration is a key factor in achieving maximal intraocular pressure (IOP) reduction. Moreover, some CAIs exhibit activity independent of CA blockade, such as inhibiting aquaporin-4. Clinical data further indicate that despite theoretical risks of systemic toxicity-particularly in individuals with comorbidities-severe adverse events are relatively rare.

Summary: In specific ocular diseases, the use of systemic CAIs is vital for maintaining vision. Although systemic CAIs carry risk of systemic adverse events, with higher risk, the incidence of severe adverse events is low and in some studies were comparable to that of topical therapy. It's important to be aware of potential side effects and ensure the correct usage of oral CAIs, especially in individuals with other systemic diseases. A tailored evaluation of risks and benefits carried out for each individual, particularly in case of prolonged usage, should decrease the risk of adverse events.

Purpose of review: Subepithelial lesions of the ocular surface represent a diverse group of pathologies which may be difficult to diagnose clinically. Some of these lesions are relatively uncommon, may result in systemic manifestations, or occur secondary to systemic disease. The purpose of this review is to summarize current approaches to the diagnosis and management of six subepithelial conjunctival lesions.

Recent findings: The standard for the diagnosis of subconjunctival lesions remains histopathologic evaluation; however, high-resolution anterior segment optical coherence tomography (HR-OCT) is a useful supplemental diagnostic tool that may facilitate diagnosis. Recent advancements in the management of subconjunctival lesions include targeted systemic therapies in conjunctival melanoma and ultra-low dose radiation radiotherapy in conjunctival lymphoma.

Summary: The development of HR-OCT has provided clinicians with valuable supplemental diagnostic information to guide the diagnosis of subepithelial lesions. Additionally, novel treatment modalities may provide an alternative to traditional surgical interventions in some pathologies.

Purpose of review: In this article, we provide a brief overview of 3D bioprinting technologies and the types of cells employed in ophthalmic cell therapy. We then explore recent applications of 3D bioprinting in ophthalmic cell delivery systems.

Recent findings: Cell therapy in ophthalmology is a promising treatment for various eye diseases, there exists some limitations of existing cell therapy strategies Such as cell loss, poor integration with Surrounding tissues, and the sustainability of long-term effects. In this regard, 3D bioprinting technology provides a beneficial method for developing highly biomimetic and reliable cell delivery systems for ophthalmic disease research. Recent advances have shown bioengineered tissues which replicate the microstructure of native tissues, personalized ophthalmic devices, and encapsulated cell-delivery systems. While still in the early stages of advancement, the development of cell delivery systems based on bioprinting technologies is indeed inspiring and has the potential to be applied to other ocular diseases.

Summary: Cell therapy based on 3D bioprinting technology in ophthalmology has great potential in ophthalmic disease treatment as well as ocular tissue engineering and regenerative medicine.

Purpose of review: This review summarizes recent advances in pediatric ophthalmic anesthesia, focusing on emergence agitation, examination under anesthesia (EUA), anesthesia strategies for retinopathy of prematurity (ROP), and care for children with developmental or medical comorbidities.

Recent findings: Emerging evidence supports multimodal approaches to reduce emergence delirium, including sub-Tenon's blocks with dexmedetomidine and intraoperative methadone. EUA protocols now emphasize streamlined exams under a single anesthetic, with some low-risk cases managed without intravenous access or general anesthesia. In ROP care, alternative strategies such as laryngeal mask airway use and bedside laser under sedation are being explored. Concerns over neurodevelopmental risks are also prompting efforts to limit cumulative anesthetic exposure through coordinated care.

Summary: Pediatric ophthalmic anesthesia is evolving toward safer, more individualized approaches. Incorporating targeted techniques and minimizing exposure can improve outcomes and inform best practices in this vulnerable population.

Purpose of review: In this article, we summarize the pathogenesis, diagnostic challenges, current management, and emerging therapeutic strategies for conjunctival melanoma (CM).

Recent findings: CM is a deadly disease with rising global incidence. Key mutations, including BRAF, NF1, and TERT, play crucial roles in CM pathogenesis and may serve as targets for therapy. Advanced imaging and histopathological analysis have improved early detection and prognostic assessment. Treatment depends on tumor stage and includes surgical excision with adjuvant chemotherapy, radiotherapy, or orbital exenteration in advanced cases. Systemic workup is always indicated. Immune checkpoint inhibitors, successful in cutaneous melanoma, show promise in CM based off early studies, although more research is needed to confirm their benefit.

Summary: CM remains a significant clinical challenge and requires a multidisciplinary approach to diagnosis and treatment. Incorporating genetic profiling and targeted therapies is crucial to improving patient outcomes.