Pub Date : 2021-01-01DOI: 10.35248/2155-9570.21.S13.001
Aditya Verma, S. Velaga, M. Nittala, Kirstie L. Baker, Xiwen Huang, J. Chhablani, S. Sadda
Background: Retinitis Pigmentosa (RP) is characterized by changes in the outer retina as well as the choroid. In this study, we sought to further elucidate the longitudinal relationship between the preserved Ellipsoid Zone (EZ) area and choroidal parameters, in particular the Choroidal Vascularity Index (CVI). Patients and methods: Spectral Domain OCT (SD-OCT) volume scans of 48 eyes of 24 subjects with autosomal dominant RP (ADRP) were collected retrospectively at baseline and month 12. Spectralis Heidelberg Retinal Angiogram (HRA+OCT) scans (20*20 degrees;512*97;ART=5) were acquired at both visits. A previously described and validated Doheny Image Reading Center (DIRC) OCT grading software (OCTOR) was used to manually delineate the inner and outer boundaries of the EZ layer and the choroid. The sub foveal choroidal thickness (CT) was manually calculated and the CVI was measured. The parameters were compared and correlated at baseline and month 12 using paired t-tests and bivariate correlations. Results: The mean preserved EZ area (P=0.02) and the mean CT (P=0.007) showed a significant decline from baseline to month 12, but no correlation was noted between them. There was no significant difference in CVI from baseline to month 12. Despite these results, the loss of preserved EZ area was seen to be correlated to the CVI at both the baseline and month 12. Conclusion: The rate of disease progression, as assessed by loss of EZ, was correlated with CVI. These observations highlight the relevance of choroidal alterations in the progression of RP.
背景:色素性视网膜炎(RP)以外视网膜和脉络膜的改变为特征。在这项研究中，我们试图进一步阐明保存的椭球区(EZ)面积与脉络膜参数，特别是脉络膜血管指数(CVI)之间的纵向关系。患者和方法:回顾性收集24例常染色体显性RP (ADRP)患者在基线和12个月时48只眼的光谱域OCT (SD-OCT)体积扫描。两次就诊均获得Spectralis Heidelberg视网膜血管造影(HRA+OCT)扫描(20*20度;512*97;ART=5)。使用先前描述并经过验证的Doheny Image Reading Center (DIRC) OCT分级软件(OCTOR)手动划定EZ层和choroid的内外边界。人工计算中央凹下脉络膜厚度(CT)，测量CVI。在基线和第12个月使用配对t检验和双变量相关性对参数进行比较和相关。结果:从基线到第12个月，平均保留EZ面积(P=0.02)和平均CT (P=0.007)显著下降，但两者之间无相关性。从基线到第12个月，CVI无显著差异。尽管有这些结果，但在基线和第12个月，保留EZ面积的损失与CVI相关。结论:以EZ丧失评估的疾病进展率与CVI相关。这些观察结果强调了脉络膜改变与RP进展的相关性。
{"title":"Relationship between Preserved Ellipsoid Zone Area and Choroidal Vascularity Index in Autosomal Dominant Retinitis Pigmentosa","authors":"Aditya Verma, S. Velaga, M. Nittala, Kirstie L. Baker, Xiwen Huang, J. Chhablani, S. Sadda","doi":"10.35248/2155-9570.21.S13.001","DOIUrl":"https://doi.org/10.35248/2155-9570.21.S13.001","url":null,"abstract":"Background: Retinitis Pigmentosa (RP) is characterized by changes in the outer retina as well as the choroid. In this study, we sought to further elucidate the longitudinal relationship between the preserved Ellipsoid Zone (EZ) area and choroidal parameters, in particular the Choroidal Vascularity Index (CVI). Patients and methods: Spectral Domain OCT (SD-OCT) volume scans of 48 eyes of 24 subjects with autosomal dominant RP (ADRP) were collected retrospectively at baseline and month 12. Spectralis Heidelberg Retinal Angiogram (HRA+OCT) scans (20*20 degrees;512*97;ART=5) were acquired at both visits. A previously described and validated Doheny Image Reading Center (DIRC) OCT grading software (OCTOR) was used to manually delineate the inner and outer boundaries of the EZ layer and the choroid. The sub foveal choroidal thickness (CT) was manually calculated and the CVI was measured. The parameters were compared and correlated at baseline and month 12 using paired t-tests and bivariate correlations. Results: The mean preserved EZ area (P=0.02) and the mean CT (P=0.007) showed a significant decline from baseline to month 12, but no correlation was noted between them. There was no significant difference in CVI from baseline to month 12. Despite these results, the loss of preserved EZ area was seen to be correlated to the CVI at both the baseline and month 12. Conclusion: The rate of disease progression, as assessed by loss of EZ, was correlated with CVI. These observations highlight the relevance of choroidal alterations in the progression of RP.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"32 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74976883","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 : 2021-01-01DOI: 10.35248/2155-9570.21.12.873
Y. Louati, C. Bergin, Sakina Ezziat, P. D. Gottrau, V. Vaclavik
Introduction: To assess the long-term findings of repeated Dexamethasone (DEX) implants in patients with Retinal Vein Occlusion (RVO) with the Intraocular Pressure (IOP) measures set as the primary end point. The second end point is the anatomical and functional findings. Methods: In this retrospective study, IOP, antiglaucoma treatment, Visual Acuity (VA), Central Macular Thickness (CMT), number of treatments, interval between treatments, and other safety outcomes data were collected at the Ophthalmology Department, Hopital Cantonal de Fribourg during 3 years. Results: Twenty-seven patients (28 eyes; 16 branch-RVO and 12 central-RVO) were eligible for analysis. Mean interval between diagnosis and treatment for treatment-naive and prior-treated patients (anti-VEGF) was 23 days and 18 months, respectively. Across six repeated treatments, IOP (i.e. ≥ 21 mmHg) was elevated in 23/27 patients, 13 received IOP-lowering medications. After the first DEX implant, mean VA improved from baseline (0.8 LogMAR (20/125 Snellen Equivalent)) at month 1 (0.6 LogMAR (20/80 approximate Snellen Equivalent)) followed by a gradual decline back to baseline at month 4. Following the first implant, mean CMT decreased from baseline (604.3 μm) to 381 μm and 426.1 μm at months 1 and 4, respectively, and remained similar until end of follow-up. A similar pattern of CMT reduction occurred following implants 2 and 3. Patients received a median of two implants, with a treatment interval of approximately 5 months. Conclusion: In a real-life clinical setting, intravitreal DEX improved VA and reduced CMT with no new safety concerns in patients with RVO. IOP elevation was transient and managed with short-term treatment with no cumulative effect on IOP elevation despite intervals <6 months , and no cases of glaucoma surgery recorded.
{"title":"Intraocular Pressure in Patients with Retinal Vein Occlusions Treated With Repeated Dexamethasone Intravitreal Implant: A Retrospective Analysis","authors":"Y. Louati, C. Bergin, Sakina Ezziat, P. D. Gottrau, V. Vaclavik","doi":"10.35248/2155-9570.21.12.873","DOIUrl":"https://doi.org/10.35248/2155-9570.21.12.873","url":null,"abstract":"Introduction: To assess the long-term findings of repeated Dexamethasone (DEX) implants in patients with Retinal Vein Occlusion (RVO) with the Intraocular Pressure (IOP) measures set as the primary end point. The second end point is the anatomical and functional findings. Methods: In this retrospective study, IOP, antiglaucoma treatment, Visual Acuity (VA), Central Macular Thickness (CMT), number of treatments, interval between treatments, and other safety outcomes data were collected at the Ophthalmology Department, Hopital Cantonal de Fribourg during 3 years. Results: Twenty-seven patients (28 eyes; 16 branch-RVO and 12 central-RVO) were eligible for analysis. Mean interval between diagnosis and treatment for treatment-naive and prior-treated patients (anti-VEGF) was 23 days and 18 months, respectively. Across six repeated treatments, IOP (i.e. ≥ 21 mmHg) was elevated in 23/27 patients, 13 received IOP-lowering medications. After the first DEX implant, mean VA improved from baseline (0.8 LogMAR (20/125 Snellen Equivalent)) at month 1 (0.6 LogMAR (20/80 approximate Snellen Equivalent)) followed by a gradual decline back to baseline at month 4. Following the first implant, mean CMT decreased from baseline (604.3 μm) to 381 μm and 426.1 μm at months 1 and 4, respectively, and remained similar until end of follow-up. A similar pattern of CMT reduction occurred following implants 2 and 3. Patients received a median of two implants, with a treatment interval of approximately 5 months. Conclusion: In a real-life clinical setting, intravitreal DEX improved VA and reduced CMT with no new safety concerns in patients with RVO. IOP elevation was transient and managed with short-term treatment with no cumulative effect on IOP elevation despite intervals <6 months , and no cases of glaucoma surgery recorded.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"34 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77038916","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 : 2021-01-01DOI: 10.35248/2155-9570.21.S13.003
Pranidhi Sharda, Praveen Panwar
We all have become slaves to our mobile phones for most of our daily activities which directly or indirectly has hazardous impact on our health and lives especially for vision. Although blast injuries are common with war, cooking gas and firecracker, but in last couple of years, mobile phone blast cases also popularly known as “BOMBILE” (Blast of Mobile Battery in Living Eye) are coming up which are time to time reported on internet and in scientific journals. We present a case series of 3 patients presented with phone battery explosion which highlights how this technology driven device created to make our lives easier can be a menace and why there is an urgent need to create awareness in society for their safe and proper handling.
{"title":"andldquo;BOMBILEandrdquo;: Newest Enemy to Our Sight? A Case Series","authors":"Pranidhi Sharda, Praveen Panwar","doi":"10.35248/2155-9570.21.S13.003","DOIUrl":"https://doi.org/10.35248/2155-9570.21.S13.003","url":null,"abstract":"We all have become slaves to our mobile phones for most of our daily activities which directly or indirectly has hazardous impact on our health and lives especially for vision. Although blast injuries are common with war, cooking gas and firecracker, but in last couple of years, mobile phone blast cases also popularly known as “BOMBILE” (Blast of Mobile Battery in Living Eye) are coming up which are time to time reported on internet and in scientific journals. We present a case series of 3 patients presented with phone battery explosion which highlights how this technology driven device created to make our lives easier can be a menace and why there is an urgent need to create awareness in society for their safe and proper handling.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"29 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75552232","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 : 2021-01-01DOI: 10.35248/2155-9570.21.S13.E001
Tessa Gabrieal
{"title":"Eye Lipids and Metabolism of Lipids in Retina","authors":"Tessa Gabrieal","doi":"10.35248/2155-9570.21.S13.E001","DOIUrl":"https://doi.org/10.35248/2155-9570.21.S13.E001","url":null,"abstract":"","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"54 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88690807","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 : 2021-01-01DOI: 10.35248/2155-9570.21.12.878
Christa Soekamto, Sabira Shrestha, J. Sohn
A 58-year-old Caucasian female presented to the clinic with progressive cloudy vision in her left eye. She had an ocular prosthesis in her right eye, and her visual acuity was 20/100 and intra-ocular pressure was 32 mm-Hg in her left eye. Exam revealed a polymethyl methacrylate (PMMA) lens with the optic and inferior haptic anterior to the iris. She had trace pigmented cells and a ring-shaped scar posterior to the iris consistent with a Soemmering's ring.. This was confirmed on ultrasound biomicroscopy and determined to be the causative etiology of her intraocular lens (IOL) dislocation.
{"title":"Intraocular Lens Dislocation Secondary to Soemmeringâs Ring","authors":"Christa Soekamto, Sabira Shrestha, J. Sohn","doi":"10.35248/2155-9570.21.12.878","DOIUrl":"https://doi.org/10.35248/2155-9570.21.12.878","url":null,"abstract":"A 58-year-old Caucasian female presented to the clinic with progressive cloudy vision in her left eye. She had an ocular prosthesis in her right eye, and her visual acuity was 20/100 and intra-ocular pressure was 32 mm-Hg in her left eye. Exam revealed a polymethyl methacrylate (PMMA) lens with the optic and inferior haptic anterior to the iris. She had trace pigmented cells and a ring-shaped scar posterior to the iris consistent with a Soemmering's ring.. This was confirmed on ultrasound biomicroscopy and determined to be the causative etiology of her intraocular lens (IOL) dislocation.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"20 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91547128","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 : 2021-01-01DOI: 10.35248/2155-9570.21.S12.001
Ana Carolina Pasquini Raiza, M. Balbino, J. T. Takiuti, Vitor K. L. Takahashi, A. DelSanto, E. Minelli, Regina Cele Silveira Seixas
Aim of the study: To determine the impact of 3D Virtual Reality on the adherence of patients to three months of treatment for glaucoma. Materials and methods: Randomized, single-blind clinical trial. Seventy patients were randomized to receive information about glaucoma via 3D Virtual Reality (3D group, 35 patients) or via printed material (control group, 35 patients). The mean measurement of both eyes from all patients was used to evaluate outcomes. The randomization was stratified to balance the number of patients using monotherapy or polytherapy between the groups. At the first appointment, patients in the 3D Virtual Reality group watched a 3D video about glaucoma; patients in the control group received information via printed material. The primary outcome measures were Intraocular Pressure (IOP), Corneal Pachymetry, and Visual Field, performed at first and the three-month appointments. Results: Neither the Corneal Pachymetry nor Visual Field changed after the three months of treatment; however, the overall IOP decreased (p=0.0001). IOP variation did not differ between monotherapy and polytherapy patients (p=0.15). Women had a trend toward better control of IOP than men, but the effect did not reach statistical significance (p=0.055). Even though overall IOP variation did not differ between the 3D and Control groups (p=0.25), the IOP decrease was higher in the 3D group than the control group, in monotherapy strata (p=0.006). Conclusion: Our data showed that 3D virtual stimulation did not improve the three-month treatment adherence of glaucoma. However, it may improve adherence in patients at early stages or less affected by the disease, such as those in monotherapy. For those patients, we recommend further studies with larger sample sizes.
{"title":"3D Virtual Reality may Enhance Adherence in Glaucoma Patients UsingMonotherapy: A Randomized Clinical Trial","authors":"Ana Carolina Pasquini Raiza, M. Balbino, J. T. Takiuti, Vitor K. L. Takahashi, A. DelSanto, E. Minelli, Regina Cele Silveira Seixas","doi":"10.35248/2155-9570.21.S12.001","DOIUrl":"https://doi.org/10.35248/2155-9570.21.S12.001","url":null,"abstract":"Aim of the study: To determine the impact of 3D Virtual Reality on the adherence of patients to three months of treatment for glaucoma. Materials and methods: Randomized, single-blind clinical trial. Seventy patients were randomized to receive information about glaucoma via 3D Virtual Reality (3D group, 35 patients) or via printed material (control group, 35 patients). The mean measurement of both eyes from all patients was used to evaluate outcomes. The randomization was stratified to balance the number of patients using monotherapy or polytherapy between the groups. At the first appointment, patients in the 3D Virtual Reality group watched a 3D video about glaucoma; patients in the control group received information via printed material. The primary outcome measures were Intraocular Pressure (IOP), Corneal Pachymetry, and Visual Field, performed at first and the three-month appointments. Results: Neither the Corneal Pachymetry nor Visual Field changed after the three months of treatment; however, the overall IOP decreased (p=0.0001). IOP variation did not differ between monotherapy and polytherapy patients (p=0.15). Women had a trend toward better control of IOP than men, but the effect did not reach statistical significance (p=0.055). Even though overall IOP variation did not differ between the 3D and Control groups (p=0.25), the IOP decrease was higher in the 3D group than the control group, in monotherapy strata (p=0.006). Conclusion: Our data showed that 3D virtual stimulation did not improve the three-month treatment adherence of glaucoma. However, it may improve adherence in patients at early stages or less affected by the disease, such as those in monotherapy. For those patients, we recommend further studies with larger sample sizes.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"32 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78948861","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 : 2021-01-01DOI: 10.35248/2155-9570.21.12.881
Alex, er Kholmanskiy, Elena Konyukhova, A. Minakhin
Synesthesia of vision and somatosensory is based on physiology of interconnection of neurons in different nuclei of thalamus or areas of cerebral cortex. Work studied effect on the intensity of Pressure Phosphenes (PP) of various methods of heating eyes and hands, as well as manual influence on cervical spine. Along with subjective assessments of the PP intensity, EEG and ECG were used for chronometry of bioelectrical activity of brain and heart. From analysis of frequency and amplitude spectra of EEG, it was concluded that mechanism of PP generation is dominated by processes of redistribution and recombination of charges in retinal and LGB layers. Stimulation of PP by heating hands was associated with convergence of LGB neurons and neurons of thalamus nuclei, which are responsible for thermoreception and are adjacent to LGB. Enhancement of effect of PP stimulation by heating hands in water and in sauna was explained by resonant mechanism of heat transfer from heated water to water of physiological fluids of epidermis and water associated with proteins of ion channels of thermoreceptor membranes. It was suggested that breakdown of water clusters in physiological fluids of epidermis at temperature above 42°C promotes to transformation of thermoreceptors into pain receptors.
{"title":"Thermal Stimulation Neurophysiology of Pressure Phosphenes","authors":"Alex, er Kholmanskiy, Elena Konyukhova, A. Minakhin","doi":"10.35248/2155-9570.21.12.881","DOIUrl":"https://doi.org/10.35248/2155-9570.21.12.881","url":null,"abstract":"Synesthesia of vision and somatosensory is based on physiology of interconnection of neurons in different nuclei of thalamus or areas of cerebral cortex. Work studied effect on the intensity of Pressure Phosphenes (PP) of various methods of heating eyes and hands, as well as manual influence on cervical spine. Along with subjective assessments of the PP intensity, EEG and ECG were used for chronometry of bioelectrical activity of brain and heart. From analysis of frequency and amplitude spectra of EEG, it was concluded that mechanism of PP generation is dominated by processes of redistribution and recombination of charges in retinal and LGB layers. Stimulation of PP by heating hands was associated with convergence of LGB neurons and neurons of thalamus nuclei, which are responsible for thermoreception and are adjacent to LGB. Enhancement of effect of PP stimulation by heating hands in water and in sauna was explained by resonant mechanism of heat transfer from heated water to water of physiological fluids of epidermis and water associated with proteins of ion channels of thermoreceptor membranes. It was suggested that breakdown of water clusters in physiological fluids of epidermis at temperature above 42°C promotes to transformation of thermoreceptors into pain receptors.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"24 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75680977","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 : 2021-01-01DOI: 10.35248/2155-9570.21.S12.003
K. Dhamdhere
Meibomian Gland Dysfunction (MGD) is the leading cause of Dry Eye Disease (DED). In MGD, obstructed meibomian glands result in reduced meibum secretion and a compromised tear lipid layer that causes tear film instability and an accelerated evaporation of tears. This accelerated and excessive tear evaporation in turn leads to the signs and symptoms of DED. Research has demonstrated that an elevated and sustained therapeutic temperature of at least 41°C at the tarsal conjunctiva located at inner surface of the eyelid can liquefy hardened or thickened meibum and help clear gland obstructions in MGD. By clearing the obstructions, restored meibomian glands can resume the production of meibum that can flow naturally out of the glands and onto the tear surface thereby restoring a stable and healthy tear film lipid layer. Fortifying the lipid layer by enhancing natural meibum production is an effective treatment for evaporative dry eye disease. In recent years, several devices have been developed that utilize thermal energy to treat DED and MGD that require heating from inside the eyelids. The medical community has debated the ability to achieve therapeutic level of temperatures at the tarsal conjunctiva via a non-invasive external approach. This article discusses a new device, TearCare, that has achieved and maintained the requisite 41°C therapeutically-effective, meibum-melting temperature at the tarsal conjunctiva non-invasively through a combination of novel features including: wearability, total tarsal conformance, blink assistance, and software sensor-controlled thermal maximization and optimization.
{"title":"A Blink-Assisted, Cornea-Sparing Wearable Eyelid Device for the EffectivePenetration of Therapeutic Thermal Energy into the Meibomian Glandsfor the Treatment of Dry Eye Disease","authors":"K. Dhamdhere","doi":"10.35248/2155-9570.21.S12.003","DOIUrl":"https://doi.org/10.35248/2155-9570.21.S12.003","url":null,"abstract":"Meibomian Gland Dysfunction (MGD) is the leading cause of Dry Eye Disease (DED). In MGD, obstructed meibomian glands result in reduced meibum secretion and a compromised tear lipid layer that causes tear film instability and an accelerated evaporation of tears. This accelerated and excessive tear evaporation in turn leads to the signs and symptoms of DED. Research has demonstrated that an elevated and sustained therapeutic temperature of at least 41°C at the tarsal conjunctiva located at inner surface of the eyelid can liquefy hardened or thickened meibum and help clear gland obstructions in MGD. By clearing the obstructions, restored meibomian glands can resume the production of meibum that can flow naturally out of the glands and onto the tear surface thereby restoring a stable and healthy tear film lipid layer. Fortifying the lipid layer by enhancing natural meibum production is an effective treatment for evaporative dry eye disease. In recent years, several devices have been developed that utilize thermal energy to treat DED and MGD that require heating from inside the eyelids. The medical community has debated the ability to achieve therapeutic level of temperatures at the tarsal conjunctiva via a non-invasive external approach. This article discusses a new device, TearCare, that has achieved and maintained the requisite 41°C therapeutically-effective, meibum-melting temperature at the tarsal conjunctiva non-invasively through a combination of novel features including: wearability, total tarsal conformance, blink assistance, and software sensor-controlled thermal maximization and optimization.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"54 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84457567","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 : 2021-01-01DOI: 10.35248/2155-9570.21.12.879
Das Gayatri, P. Veena
Purpose: The global rise in the prevalence of myopia calls for evidence-based strategies to be devised to reduce the incidence and delay the progression of Myopia. The aim of this study is to review the current literature on modifiable environmental risk factors that control the development and progression of Myopia, specifically in paediatric population. Method: A comprehensive literature review was conducted using PubMed, ScienceDirect, Elsevier, and Google Scholar databases, including keywords such as "environmental risk factors"; "myopia"; “outdoor activity”; “near work”; “high body mass index”; “LED lamps usage”; “watching television”; “digital devices”; “sleep”; “melatonin”; “low vitamin D levels”; “sports”; “socioeconomic status”; “COVID-19 and online education”. English language full-text articles published between Jan 2010 and Oct 2020 were included in the study. Studies were critically reviewed for study methodology and robustness of data. Thirty six studies are included in this literature review. Conclusion: Prevention of onset of myopia and delay in progression of myopia can be altered by modifying the contributing environmental risk factors. Increase in outdoor time with adequate sunlight exposure, rural environment, less duration of near work, use of incandescent lamp, normal circadian rhythms with adequate regular sleeping hours can prevent the onset and progression of myopia. Myopia association with high BMI, watching television, playing digital devices, serum vitamin D levels, participation in sports yet to be established. High socioeconomic status associated with more indoor activity, increased academic pressure, sedentary life style contributes to prevalence of myopia. COVID-19 pandemic control measures with consequent online education resulted in increased digital screen time, near work, and limited outdoor activities, causing rise of myopia pandemic.
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