Eye最新文献

Background/objectives: To assess the effectiveness and safety of 0.19-mg fluocinolone acetonide implant (FAc-implant) in inflammatory macular oedema (MO).

Subjects/methods: This observational, retrospective, multicentre cohort included consecutive eyes treated with FAc-implant between June 2020 and January 2024 for recurrent uveitic or postoperative MO requiring at least two prior dexamethasone-implants (DEX-implants) and ≥6 months of follow-up. The primary endpoints were best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 6, 12, 18, and 24 months. The secondary endpoints were anatomical and functional outcomes, additional treatments and safety outcomes (intraocular pressure (IOP), ocular hypertension (OHT)).

Results: A total of 73 eyes were included, with a mean follow-up of 16.8 (8.4) months. The median difference in BCVA was +4.0 [0.0;10.0] (p < 0.001), +2.0 [0.0;9.0] (p = 0.006), +5.0 [0.0;10.0] (p = 0.010) and +5.0 [0.0;9.0] (p = 0.043) letters at 6, 12, 18 and 24 months. The median difference in CMT was -71.0 [-181.3;-25.5] (p < 0.001), -71.0 [-195.0;-30.5] (p < 0.001), -75.0 [194.0;-43.0] (p < 0.001) and -154.0 [-253.0;-110.0] (p < 0.001) μm at 6, 12, 18 and 24 months. Over the follow-up, 38 eyes (52.1%) did not require any additional intravitreal treatment. At 12 months after FAc-implant, the probability of not receiving a rescue injection of DEX-implant was 54.0% [43.0%;67.0%]. Eight eyes (11.0%) developed OHT (IOP ≥ 25 mmHg or an increase in IOP ≥ 10 mmHg), mostly resolved by IOP-lowering eye drops; two eyes required surgery.

Conclusions: This real-life study shows the functional and anatomical effectiveness of the FAcimplant in recurrent inflammatory MO, with limited adverse effects and a reduced treatment burden.

Studies show that exposure to air pollutants is linked to eye diseases, but they don't specify the impact on different eye structures. This study aims to analyse the risk of ocular surface, anterior and middle segment and fundus eye diseases among individuals exposed to common and specific air pollutants. Seven databases were searched for relevant studies published between January 2000 and August 2024. Inclusion criteria encompassed individuals of all ages, with studies providing associations between common air pollutants (carbon monoxide [CO], nitrous oxide [NO], nitrogen dioxide [NO₂], sulphur dioxide [SO₂], ozone [O₃], black carbon, particulate matter [PM], environmental tobacco smoke [ETS]), specific air pollutants (volatile organic compounds [VOCs] in cosmetics, smoke from indoor solid fuel cookers, biomass fuel use and road dust). Pooled odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated. A total of 55 studies were included. Consistent evidence of associations was found between air pollutant exposure and eye diseases, with 51 studies reporting positive associations. The combined overall result was OR = 1.26 (95% CI, 1.20-1.32). Additionally, evidence of associations was observed for ocular surface diseases (OR = 1.29, 95% CI, 1.20-1.39), anterior and middle segment diseases (OR = 1.22, 95% CI, 1.14-1.31) and fundus oculi diseases (OR = 1.35, 95% CI, 1.17-1.57). In conclusion, the meta-analysis suggests air pollutant exposure is associated with ocular diseases, with the highest pooled risk for fundus diseases, though direct comparisons are limited by study heterogeneity.

Purpose: To characterise peri-injury systemic health changes in patients with fall-related open globe injuries (OGIs).

Design: Retrospective cohort study.

Participants: 162 patients with fall-related OGIs, identified from a cohort of 1016 consecutive OGIs treated at a single academic medical center between 2016 and 2024.

Methods: Electronic medical records were reviewed. Patients were included if the injury resulted from a fall and sufficient systemic health data were available.

Main outcome measures: Incidence of new systemic diagnoses, disease exacerbations, and medication changes occurring within 90 days before or after the OGI. Specialist visits within the window and one-year mortality data were secondary measures.

Results: Of 1016 OGIs, 223 were fall-related (59.3% female, mean age 73.7 ± 14.3). Of 162 patients meeting inclusion criteria, 103 (63.6%) had at least one new systemic diagnosis likely contributing to the fall. Forty-three patients (26.5%) experienced exacerbation of pre-existing conditions, 28 (65.1%) of which were considered contributory to the fall. A total of 351 medication changes were documented, including medication classes with known fall risk. Seventy patients (43.2%) were seen by a new specialist; 38 of 108 visits (35.2%) were trauma-related, while 70 (64.8%) addressed new non-ocular conditions. Age-stratified one-year mortality rates were: ≤65 years, 9.7%; 66-75, 15.0%; 76-85, 16.7%; >85, 45.0%.

Conclusions: Most fall-related OGIs occur in the context of newly diagnosed systemic illness, worsening of chronic disease, or medication changes. These injuries may represent sentinel events signaling underlying health deterioration. Systemic evaluation at initial presentation could facilitate timely referral and management of serious non-ophthalmic conditions.