International Ophthalmology Clinics最新文献

Mpox (formerly known as monkeypox), an infectious disease caused by the monkeypox virus (MPXV), has been endemic in regions of Central and Western Africa. In 2022, the global spread of the clade IIb MPXV led to a multinational outbreak, primarily affecting sexual transmission networks among men who have sex with men. Despite interventions, new cases have continued to emerge. In Africa, the spread of a novel strain of clade I MPXV, clade Ib, has prompted a Public Health Emergency of International Concern designation by the World Health Organization in August 2024. This article provides an updated overview of the epidemiology, systemic, and ocular manifestations, highlighting the clinical features, diagnostic testing, and implications relevant to ophthalmologists and eye care providers, including infection prevention and control measures. The ocular manifestations of mpox primarily involve the ocular surface and anterior segment, with presentations ranging from conjunctivitis to severe, vision-threatening keratitis and uveitis. While the 2022 to 2024 Clade IIb outbreak has shown a lower incidence of ocular involvement compared with previous outbreaks, the potential for significant visual morbidity remains. Treatment involves both systemic and topical therapies, with tecovirimat being the primary systemic option, though its efficacy and ophthalmic bioavailability remain under investigation. Ongoing surveillance and research are essential to further understand the epidemiology and ophthalmic features of mpox and, ultimately, to optimize prevention and treatment strategies for patients.

Objective/purpose: Compare outcomes and costs of TNF-alpha inhibitor biosimilars to reference medications in the treatment of pediatric NIU.

Methods: Patients 18 years old or below treated with reference or biosimilar TNF-alpha inhibitor for noninfectious uveitis and had a history of active ocular inflammation with at least 1 month of ophthalmology follow-up from January 1, 2013, to June 1, 2023, were included. Retrospective chart review was performed.

Results: Nineteen patients met the inclusion criteria. Mean age was 9.3±4.0 years, and 47.4% (9/19) were female. Of the patients who were on infliximab at any time point in their disease course (n=9), the mean duration on infliximab was 3.6 years (42 mo). Of the patients on biosimilar infliximab (n=10), the mean duration was 0.82 years (9.8 mo). Mean flares/year was 0.22±0.3 on infliximab and 0.15±0.3 on biosimilar infliximab. The average annual cost was $42,298.97 for infliximab (n =9), $41,141 for infliximab-dyyb (n=9), and $40,950 for infliximab-axxq (n=1). Reasons for switching to biosimilar infliximab from adalimumab included a combination of insurance mandate (100%), worsening disease activity (37.5%), or other issues such as noncompliance (37.5%).

Conclusions: The most common reason for biosimilar initiation was insurance mandate. Compared with the reference infliximab, pediatric patients had fewer number of flares per year on biosimilar infliximab, but they were also on the biosimilar for a shorter duration of time compared with the reference which may confound an accurate assessment. Biosimilar infliximab had a lower cost profile compared with reference infliximab.

The integration of skincare into medical practice can enhance patient care. Understanding the anatomy and physiology of the skin is the foundation for effective skincare interventions. Genetic and inflammatory conditions play a significant role in aesthetic skin physiology. There are key active ingredients that are pivotal in addressing various skin concerns. Sunscreens provide crucial protection against UV radiation, while pigment control agents such as hydroquinone, kojic acid, and arbutin target the melanin pathway. Exfoliating agents and skin turnover enhancers such as retinoids and hydroxy acids promote skin renewal and rejuvenation. In addition, ingredients such as hyaluronic acid, ceramides, niacinamide, antioxidants, peptides, and botanicals contribute to improving skin quality. Adding skincare to medical practice requires careful product selection, patient education, and marketing strategies.

Intense pulsed light has a growing body of research supporting its use in skin rejuvenation, dermatologic conditions, as well as ocular rosacea, dry eyes and meibomian gland dysfunction. This paper will start with the conception of one protocol for treating dry eyes, blepharitis and styes using broad band light, a version of intense pulsed light, and its evolution into a life-changing in-office procedure for many patients. The approach for optimizing the settings, considerations during the consultation, the procedure in detail, after treatment care, and potential complications to avoid are all explained. Periocular and facial rejuvenation treatment protocols are discussed as well. This should be a useful guide for clinicians looking to add intense pulsed light to their in-office treatment armamentarium to significantly improve the lives of their patients.