Pub Date : 2016-08-04DOI: 10.17925/EOR.2016.10.01.17
Simon R. J. Taylor
The treatment of uveitis is undergoing significant change as a result of the development of new therapeutic approaches, of which the biologic agents form a major part. These targeted therapies have shown great promise for the treatment of refractory disease and some have now undergone systematic evaluation through prospective clinical trials, unlike many of their predecessor drugs.
{"title":"Biologic Therapy in Uveitis","authors":"Simon R. J. Taylor","doi":"10.17925/EOR.2016.10.01.17","DOIUrl":"https://doi.org/10.17925/EOR.2016.10.01.17","url":null,"abstract":"The treatment of uveitis is undergoing significant change as a result of the development of new therapeutic approaches, of which the biologic agents form a major part. These targeted therapies have shown great promise for the treatment of refractory disease and some have now undergone systematic evaluation through prospective clinical trials, unlike many of their predecessor drugs.","PeriodicalId":112480,"journal":{"name":"European Ophthalmic Review","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132017164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.17925/EOR.2007.00.00.45
César Villa, J. Jiménez, J. González-Méijome
{"title":"Objective Evaluation of Night Visual Distortion","authors":"César Villa, J. Jiménez, J. González-Méijome","doi":"10.17925/EOR.2007.00.00.45","DOIUrl":"https://doi.org/10.17925/EOR.2007.00.00.45","url":null,"abstract":"","PeriodicalId":112480,"journal":{"name":"European Ophthalmic Review","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117285813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.17925/EOR.2014.08.02.99
J. Vryghem, S. Heireman, T. Devogelaere
Objective: To evaluate clinical results of a high-frequency, low-energy, small spot femtosecond laser for the creation of thin corneal flaps in laser in situ keratomileusis (LASIK) used in a comparative case series at a private practice in Brussels, Belgium. Methods: A series of 75 patients selected for LASIK refractive surgery were enrolled for treatment with the Ziemer FEMTO LDV femtosecond laser and received a corneal flap of either 90 μm (59 patients, 103 eyes) or 80 μm (16 patients, 27 eyes) nominal thickness. Prospective evaluation included flap dimensions, intraand post-operative complications and visual outcomes. Results: Mean flap thickness was 89.03 (standard deviation [SD]: ± 8.26 μm) in the 90 μm group and 81.91 (SD ± 6.80 μm) in the 80 μm group. Mean uncorrected visual was 1.19 ± 0.26 in the 90 μm group and 1.10 ± 0.25 in the 80 μm group. Mean manifest refractive spherical equivalent was –0.12 ± 0.26 D in the 90 μm group and –0.07 ± 0.31 D in the 80 μm group. There was no significant visual loss (≥2 lines loss of best corrected visual acuity) in either group. One flap tear occurred in the 90 μm group (0.97 %) and two pseudo-buttonholes occurred in the 80 μm group (7.41 %). No other clinically relevant complications occurred intraor post-operatively. Conclusions: The Ziemer LDV femtosecond laser offers a high degree of precision in the creation of 90 and 80 μm flaps for LASIK. Using this device for creating 90 μm flaps can be considered a safe and effective procedure. A higher rate of complications were shown in 80 μm flaps.
{"title":"Thin-flap LASIK with a High-frequency, Low-energy, Small Spot Femtosecond Laser – Effectiveness and Safety","authors":"J. Vryghem, S. Heireman, T. Devogelaere","doi":"10.17925/EOR.2014.08.02.99","DOIUrl":"https://doi.org/10.17925/EOR.2014.08.02.99","url":null,"abstract":"Objective: To evaluate clinical results of a high-frequency, low-energy, small spot femtosecond laser for the creation of thin corneal flaps in laser in situ keratomileusis (LASIK) used in a comparative case series at a private practice in Brussels, Belgium. Methods: A series of 75 patients selected for LASIK refractive surgery were enrolled for treatment with the Ziemer FEMTO LDV femtosecond laser and received a corneal flap of either 90 μm (59 patients, 103 eyes) or 80 μm (16 patients, 27 eyes) nominal thickness. Prospective evaluation included flap dimensions, intraand post-operative complications and visual outcomes. Results: Mean flap thickness was 89.03 (standard deviation [SD]: ± 8.26 μm) in the 90 μm group and 81.91 (SD ± 6.80 μm) in the 80 μm group. Mean uncorrected visual was 1.19 ± 0.26 in the 90 μm group and 1.10 ± 0.25 in the 80 μm group. Mean manifest refractive spherical equivalent was –0.12 ± 0.26 D in the 90 μm group and –0.07 ± 0.31 D in the 80 μm group. There was no significant visual loss (≥2 lines loss of best corrected visual acuity) in either group. One flap tear occurred in the 90 μm group (0.97 %) and two pseudo-buttonholes occurred in the 80 μm group (7.41 %). No other clinically relevant complications occurred intraor post-operatively. Conclusions: The Ziemer LDV femtosecond laser offers a high degree of precision in the creation of 90 and 80 μm flaps for LASIK. Using this device for creating 90 μm flaps can be considered a safe and effective procedure. A higher rate of complications were shown in 80 μm flaps.","PeriodicalId":112480,"journal":{"name":"European Ophthalmic Review","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121235684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.17925/EOR.2018.12.2.85
G. Rossi
urpose : To consider the effects of announcing the diagnosis of glaucoma and to record the patients’ knowledge of the disease. Methods : Patients treated for primary open angle glaucoma completed a questionnaire at a regular visit to their ophthalmologist. The questions recorded the patients’ reaction to the diagnosis and the information received. Patients have been studied by sex and age. Results are presented as frequencies and percentages. Differences were evaluated by means of Chi-square statistic or Fisher exact test. Results : One hundred and twelve patients completed the questionnaire. Eighty-seven (77.7%) patients reported negative emotions after diagnosis: 41 (36.6%) were afraid of going blind and 31 (27.7%) experienced anxiety (younger patients more than older patients; p=0.048). Nearly half of the patients declared that they had modified their behaviour, indicating they took more care of their eyes (mainly young patients and women). Seventy-seven (68.7%) patients were satisfied with the information and care given. Only 26 (23.2%) cited inheritance and elevated intraocular pressure as causes of glaucoma. Many patients asked for more information on the causes, evolution and prevention of the disease. Younger patients (n=40; 93.0%) and women (n=52; 89.6%) asked more questions. Conclusion : Announcing a diagnosis of glaucoma is a fundamental step in the physician–patient relationship. This disease negatively influences quality of life due to its chronic nature: better patient-tailored information is necessary. Although age and sex influence the reactions to diagnosis and the satisfaction with the information and care given, most of the patients were satisfied with their eye specialists.
{"title":"Age and Gender Influence Reaction to Glaucoma Diagnosis","authors":"G. Rossi","doi":"10.17925/EOR.2018.12.2.85","DOIUrl":"https://doi.org/10.17925/EOR.2018.12.2.85","url":null,"abstract":"urpose : To consider the effects of announcing the diagnosis of glaucoma and to record the patients’ knowledge of the disease. Methods : Patients treated for primary open angle glaucoma completed a questionnaire at a regular visit to their ophthalmologist. The questions recorded the patients’ reaction to the diagnosis and the information received. Patients have been studied by sex and age. Results are presented as frequencies and percentages. Differences were evaluated by means of Chi-square statistic or Fisher exact test. Results : One hundred and twelve patients completed the questionnaire. Eighty-seven (77.7%) patients reported negative emotions after diagnosis: 41 (36.6%) were afraid of going blind and 31 (27.7%) experienced anxiety (younger patients more than older patients; p=0.048). Nearly half of the patients declared that they had modified their behaviour, indicating they took more care of their eyes (mainly young patients and women). Seventy-seven (68.7%) patients were satisfied with the information and care given. Only 26 (23.2%) cited inheritance and elevated intraocular pressure as causes of glaucoma. Many patients asked for more information on the causes, evolution and prevention of the disease. Younger patients (n=40; 93.0%) and women (n=52; 89.6%) asked more questions. Conclusion : Announcing a diagnosis of glaucoma is a fundamental step in the physician–patient relationship. This disease negatively influences quality of life due to its chronic nature: better patient-tailored information is necessary. Although age and sex influence the reactions to diagnosis and the satisfaction with the information and care given, most of the patients were satisfied with their eye specialists.","PeriodicalId":112480,"journal":{"name":"European Ophthalmic Review","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127352110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.17925/EOR.2017.11.01.44
M. Ozturk, M. L. Harris, H. Mehta
{"title":"An Evidence-based Approach to Using Intravitreal Steroids in the Management of Diabetic Macular Oedema","authors":"M. Ozturk, M. L. Harris, H. Mehta","doi":"10.17925/EOR.2017.11.01.44","DOIUrl":"https://doi.org/10.17925/EOR.2017.11.01.44","url":null,"abstract":"","PeriodicalId":112480,"journal":{"name":"European Ophthalmic Review","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123583177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.17925/EOR.2014.08.01.40
G. Rossi
Glaucoma and ocular surface disease (OSD) are often concomitant disorders (OSD is the consequence of a tear film dysfunction that may be due to several conditions). The aims of the paper are to suggest a sequence of diagnostic tests easy to perform in daily practice, both subjective and objective, to detect the onset of the OSD; and, second, to propose how to prevent and, if the case, how to manage the OSD. Briefly, tear film break-up time (TF-BUT) and corneal/conjunctival staining are suggested to detect the main signs of OSD. In terms of therapy, the long-term exposure to benzalkonium chloride (BAK) should be minimised, preferring non-BAK-preserved or BAK-free glaucoma medications, where available, as well as fixed combinations. The treatment of associated diseases of the anterior surface may reduce signs; use of non BAK-preserved tears may reduce symptoms.
{"title":"Diagnosis and Treatment Methods for Ocular Surface Disease in Glaucoma","authors":"G. Rossi","doi":"10.17925/EOR.2014.08.01.40","DOIUrl":"https://doi.org/10.17925/EOR.2014.08.01.40","url":null,"abstract":"Glaucoma and ocular surface disease (OSD) are often concomitant disorders (OSD is the consequence of a tear film dysfunction that may be due to several conditions). The aims of the paper are to suggest a sequence of diagnostic tests easy to perform in daily practice, both subjective and objective, to detect the onset of the OSD; and, second, to propose how to prevent and, if the case, how to manage the OSD. Briefly, tear film break-up time (TF-BUT) and corneal/conjunctival staining are suggested to detect the main signs of OSD. In terms of therapy, the long-term exposure to benzalkonium chloride (BAK) should be minimised, preferring non-BAK-preserved or BAK-free glaucoma medications, where available, as well as fixed combinations. The treatment of associated diseases of the anterior surface may reduce signs; use of non BAK-preserved tears may reduce symptoms.","PeriodicalId":112480,"journal":{"name":"European Ophthalmic Review","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123702841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.17925/EOR.2012.06.03.169
M. Nardi
Nepafenac ophthalmic suspension is a topical non-steroidal anti-inflammatory drug (NSAID) approved in the US and Europe for prevention and treatment of post-operative pain and inflammation associated with cataract surgery, and recently approved in Europe for reduction in risk of post-operative macular oedema associated with cataract surgery in diabetic patients. Unlike conventional NSAIDs, nepafenac is a prodrug that is uncharged and this results in great corneal permeability. Experimental studies on nepafenac demonstrated enhanced permeability compared with other NSAIDs, and rapid bioactivation to amfenac by intraocular hydrolases within ocular tissues including ciliary body epithelium, retina, choroid and cornea, which results in targeted delivery of active drug to anterior and posterior segments. Furthermore, these study results have been confirmed in clinical trials. Nepafenac may have prolonged activity in vascularised tissues of the eye because bioconversion is targeted to the iris/ciliary body, and to a greater extent the retina and choroid. Nepafenac and amfenac are potent inhibitors of cyclo-oxygenase (COX) enzyme isoforms, COX-1 and COX-2. Topical nepafenac penetrated into the posterior segment in a rabbit model of concanavalin-A induced retinal inflammation, where it diminished vitreous protein and prostaglandin E2 concentrations and reduced breakdown of the blood–retinal barrier. Other NSAIDs, including ketorolac, failed to reduce the increase of these inflammatory markers in the same study. A randomised clinical study showed that based on retinal thickening and vision, treatment with nepafenac beginning pre-surgery and used for up to 90 days post-cataract surgery is effective in preventing macular oedema and associated loss of visual acuity in diabetic patients.
{"title":"Nepafenac in the Prevention and Treatment of Ocular Inflammation and Pain Following Cataract Surgery and in the Prevention of Post-operative Macular Oedema in Diabetic Patients","authors":"M. Nardi","doi":"10.17925/EOR.2012.06.03.169","DOIUrl":"https://doi.org/10.17925/EOR.2012.06.03.169","url":null,"abstract":"Nepafenac ophthalmic suspension is a topical non-steroidal anti-inflammatory drug (NSAID) approved in the US and Europe for prevention and treatment of post-operative pain and inflammation associated with cataract surgery, and recently approved in Europe for reduction in risk of post-operative macular oedema associated with cataract surgery in diabetic patients. Unlike conventional NSAIDs, nepafenac is a prodrug that is uncharged and this results in great corneal permeability. Experimental studies on nepafenac demonstrated enhanced permeability compared with other NSAIDs, and rapid bioactivation to amfenac by intraocular hydrolases within ocular tissues including ciliary body epithelium, retina, choroid and cornea, which results in targeted delivery of active drug to anterior and posterior segments. Furthermore, these study results have been confirmed in clinical trials. Nepafenac may have prolonged activity in vascularised tissues of the eye because bioconversion is targeted to the iris/ciliary body, and to a greater extent the retina and choroid. Nepafenac and amfenac are potent inhibitors of cyclo-oxygenase (COX) enzyme isoforms, COX-1 and COX-2. Topical nepafenac penetrated into the posterior segment in a rabbit model of concanavalin-A induced retinal inflammation, where it diminished vitreous protein and prostaglandin E2 concentrations and reduced breakdown of the blood–retinal barrier. Other NSAIDs, including ketorolac, failed to reduce the increase of these inflammatory markers in the same study. A randomised clinical study showed that based on retinal thickening and vision, treatment with nepafenac beginning pre-surgery and used for up to 90 days post-cataract surgery is effective in preventing macular oedema and associated loss of visual acuity in diabetic patients.","PeriodicalId":112480,"journal":{"name":"European Ophthalmic Review","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126781889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.17925/EOR.2015.09.02.130
R. Natale
Prostaglandins are the most prescribed glaucoma drugs all over Europe; however, great differences exist from country to country in drugs prevalence. Generics represent an important glaucoma market share. The economic situation and local restriction to healthcare expenditure may influence physician choice in drugs prescription.
{"title":"Trends and Discrepancies in Glaucoma Medical Therapy in Europe","authors":"R. Natale","doi":"10.17925/EOR.2015.09.02.130","DOIUrl":"https://doi.org/10.17925/EOR.2015.09.02.130","url":null,"abstract":"Prostaglandins are the most prescribed glaucoma drugs all over Europe; however, great differences exist from country to country in drugs prevalence. Generics represent an important glaucoma market share. The economic situation and local restriction to healthcare expenditure may influence physician choice in drugs prescription.","PeriodicalId":112480,"journal":{"name":"European Ophthalmic Review","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114888517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.17925/EOR.2009.02.01.64
A. Ertan, Günhal Kamburoğlu
The structural properties of collagen framework in the corneal stroma determine the biomechanical and optical properties of tissue. Optimal corneal optics requires a smooth, regular surface with a healthy tear film and epithelium. The regular arrangement of stromal cells and macromolecules is necessary for clear vision. The lattice arrangement of collagen fibrils embedded in the extracellular matrix acts as a diffraction grating to reduce light scattering by means of destructive interference. Scattering is greater anteriorly, resulting in a higher refractive index that decreases from 1.401 at the epithelium to 1.380 in the stroma and 1.373 posteriorly. With normal collagen regulation we can see clearly because the lattice elements are smaller than the wavelength of visible light.1 This is disrupted in keratoconic corneas owing to loss of arrangement of fibrils in the anterior stroma, a decrease in the number of collagen lamellae and separation of collagen bundles.2,3 A new treatment based on collagen cross-linking (CCL) has now been introduced by Wollensak.4,5 This new treatment is aimed at the pathogenic cause of keratoconus and changes the intrinsic biomechanical properties of corneal collagen.
{"title":"Controversies in Cross-linking Treatment for Keratoconus","authors":"A. Ertan, Günhal Kamburoğlu","doi":"10.17925/EOR.2009.02.01.64","DOIUrl":"https://doi.org/10.17925/EOR.2009.02.01.64","url":null,"abstract":"The structural properties of collagen framework in the corneal stroma determine the biomechanical and optical properties of tissue. Optimal corneal optics requires a smooth, regular surface with a healthy tear film and epithelium. The regular arrangement of stromal cells and macromolecules is necessary for clear vision. The lattice arrangement of collagen fibrils embedded in the extracellular matrix acts as a diffraction grating to reduce light scattering by means of destructive interference. Scattering is greater anteriorly, resulting in a higher refractive index that decreases from 1.401 at the epithelium to 1.380 in the stroma and 1.373 posteriorly. With normal collagen regulation we can see clearly because the lattice elements are smaller than the wavelength of visible light.1 This is disrupted in keratoconic corneas owing to loss of arrangement of fibrils in the anterior stroma, a decrease in the number of collagen lamellae and separation of collagen bundles.2,3 A new treatment based on collagen cross-linking (CCL) has now been introduced by Wollensak.4,5 This new treatment is aimed at the pathogenic cause of keratoconus and changes the intrinsic biomechanical properties of corneal collagen.","PeriodicalId":112480,"journal":{"name":"European Ophthalmic Review","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115044755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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