Therapeutic Advances in Ophthalmology最新文献_第7页

Disc–fovea distance and choroidal thickness: is there a relationship? 椎间盘-中央凹距离与脉络膜厚度有关系吗?

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414221096062

Selim Cevher, M. Barış Üçer, T. Şahin

Background: The distance between the optic disc center and the fovea is a biometric parameter; however, it is unclear whether DFD (disc–fovea distance) affects the choroidal thickness. Objective: The aim of this study is to investigate the association between DFD and choroidal thickness. Design: This is a prospective, and cross-sectional study. Methods: Two hundred fifty eyes of 250 healthy participants were examined in terms of DFD, age, axial length, spherical equivalent, and choroidal thickness. Inclusion criteria included aged between 20–40 years, no posterior segment disorders, and participants with best-corrected visual acuity (10/10 according to Snellen’s chart). Participants with high hypermetropia (>4 diopter) or myopia (>6 diopter) or any systemic disease likely to affect choroidal thickness were excluded. Choroidal thickness measurements were performed at subfoveal, 1.0 mm temporal, and 1.0 mm nasal using the enhanced-depth imaging optical coherence tomography. Results: The mean age of all the participants was 26.21 ± 5.73 years, mean DFD was 4634.29 ± 274.70 µm, mean axial length was 23.62 ± 0.83 mm, and mean spherical equivalent was −0.61 ± 1.06 diopter. The mean subfoveal, nasal, and temporal choroidal thicknesses were 388.73 ± 90.15 µm, 351.26 ± 88.09 µm, and 366.50 ± 79.56 µm, respectively. A negative correlation was found between subfoveal, nasal, and temporal choroidal thicknesses and axial length (r = −0.157, p = 0.013; r = −0.168, p = 0.008; r = −0.174, p = 0.006, respectively). Insignificant correlation was found between choroidal thicknesses and spherical equivalent (p > 0.05). There was not a statistically significant correlation between DFD and subfoveal, nasal, and temporal choroidal thicknesses (r = −0.028, p = 0.655; r = 0.030, p = 0.641; r = −0.025, p = 0.699, respectively). In addition, there was not a statistically significant correlation between age and choroidal thickness. Conclusion: This study shows that DFD and spherical equivalent do not affect choroidal thickness; axial length negatively affects choroidal thickness. In addition, age does not affect choroidal thickness between 20 and 40 years.

背景：视盘中心和中央凹之间的距离是一个生物特征参数；然而，目前尚不清楚DFD（椎间盘-中央凹距离）是否会影响脉络膜厚度。目的：探讨DFD与脉络膜厚度的关系。设计：这是一项前瞻性的横断面研究。方法：对250名健康参与者的250只眼睛进行DFD、年龄、眼轴长度、球当量和脉络膜厚度检查。纳入标准包括年龄在20-40岁之间，没有后段疾病，以及矫正视力最佳的参与者（根据Snellen的图表，10/10）。排除患有高度远视（>4屈光度）、近视（>6屈光度）或任何可能影响脉络膜厚度的系统性疾病的参与者。使用增强深度成像光学相干断层扫描在腔下、1.0mm颞叶和1.0mm鼻腔进行脉络膜厚度测量。结果：所有参与者的平均年龄为26.21岁 ± 5.73年，平均DFD为4634.29 ± 274.70µm，平均轴向长度为23.62 ± 0.83 mm，平均球形当量为-0.61 ± 1.06屈光度。脉络膜下、鼻腔和颞部的平均厚度为388.73 ± 90.15µm，351.26 ± 88.09µm和366.50 ± 79.56µm。脉络膜下、鼻腔和颞叶厚度与轴向长度呈负相关（r = −0.157，p = 0.013；r = −0.168，p = 0.008；r = −0.174，p = 0.006）。脉络膜厚度与球当量之间无显著相关性（p > 0.05）。DFD与下腔、鼻腔和颞叶脉络膜厚度之间没有统计学上显著的相关性（r = −0.028，p = 0.655；r = 0.030，p = 0.641；r = −0.025，p = 0.699）。此外，年龄和脉络膜厚度之间没有统计学意义的相关性。结论：本研究表明DFD和球形等效物不影响脉络膜厚度；轴向长度对脉络膜厚度有负面影响。此外，年龄在20至40岁之间不会影响脉络膜厚度。

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引用次数: 0

The effect of amblyopia on balance and gait. 弱视对平衡和步态的影响。

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414221141380

Ali Nouraeinejad

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Ther Adv Ophthalmol

引用次数: 1

Assessment of corneal endothelial cell morphology and anterior segment parameters in COVID-19. COVID-19患者角膜内皮细胞形态及前段参数的评估。

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414221096057

Burak Oren, Dilara Ozkoyuncu Kocabas

Background: The ocular manifestations of the 2019 novel coronavirus disease (COVID-19) vary from acute follicular, pseudomembranous, and hemorrhagic conjunctivitis to keratoconjunctivitis with subepithelial infiltrates and dendritic lesions. Similar to other respiratory viruses, such as adenoviruses, it is thought that COVID-19 may impact the cornea. However, its impact on the cornea and anterior segment parameters are currently poorly understood.

Objective: This study aims to assess the corneal endothelial cell morphology and anterior segment parameters in patients who have recovered from COVID-19.

Methods: In this cross-sectional study, the COVID-19 group comprised 34 patients who had been diagnosed with and recovered from COVID-19, while the control group comprised age- and sex-matched individuals without any systemic or ocular diseases. The endothelial cell density (ECD), coefficient of variation (CV) of cell area, hexagonal cell percentage (HEX), anterior chamber depth (ACD), central corneal thickness (CCT), horizontal anterior chamber diameter (HACD), iridocorneal angle (ICA), horizontal visible iris diameter (HVID), pupillary diameter (PD), and keratometry values (K1 and K2) were analyzed for each participant. The differences in each of these between the groups were analyzed using either an independent samples t test or a Mann-Whitney U test based on the normality of the data.

Results: Regarding corneal endothelial cell morphology, the ECDs for the COVID-19 and control groups were 2278.50 ± 186.78 cells/mm² and 2420.15 ± 222.25 cells/mm², respectively (p = 0.002). A significant increase was noted in CV values in the COVID-19 group compared with the control group (p < 0.001). The HEX values for the COVID-19 and control groups were 56.26 ± 5.75 and 61.50 ± 3.63, respectively (p < 0.001). Regarding the anterior segment parameters, no significant differences were observed between the groups (p > 0.05).

Conclusions: It was hypothesized that individuals who had recovered from COVID-19 would demonstrate a reduction in their endothelial functional preserves. A decrease in ECD and HEX and an increase in CV were observed in the individuals during their early post-recovery period from COVID-19.

背景:2019年新型冠状病毒病(COVID-19)的眼部表现从急性滤泡性、假膜性和出血性结膜炎到角膜结膜炎伴上皮下浸润和树突状病变不等。与其他呼吸道病毒(如腺病毒)类似，人们认为COVID-19可能会影响角膜。然而，其对角膜和前节参数的影响目前尚不清楚。目的:本研究旨在评估COVID-19康复患者角膜内皮细胞形态和前段参数。方法:在本横断面研究中，COVID-19组包括34例已诊断并从COVID-19中康复的患者，而对照组包括年龄和性别匹配的无任何全身或眼部疾病的个体。分析每位受试者的内皮细胞密度(ECD)、细胞面积变异系数(CV)、六边形细胞百分比(HEX)、前房深度(ACD)、角膜中央厚度(CCT)、水平前房直径(HACD)、虹膜-角膜角(ICA)、水平可见虹膜直径(HVID)、瞳孔直径(PD)和角膜测量值(K1和K2)。使用独立样本t检验或基于数据正态性的Mann-Whitney U检验来分析各组之间的差异。结果:在角膜内皮细胞形态学方面，COVID-19组和对照组的ECDs分别为2278.50±186.78 cells/mm2和2420.15±222.25 cells/mm2 (p = 0.002)。与对照组相比，COVID-19组CV值显著升高(p p p > 0.05)。结论:假设从COVID-19中恢复的个体会表现出内皮功能保留的减少。在从COVID-19恢复后的早期阶段，观察到个体的ECD和HEX下降，CV增加。

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引用次数: 5

Comprehensive overview of IRVAN syndrome: a structured review of Case Reports and Case Series IRVAN综合征的全面综述：病例报告和病例系列的结构化综述

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414211070880

H. Khan, Q. A. Khan, M. Shahzad, M. Awan, N. Khan, Sm Jahangir, F. Shaheen, Kamran Wali, Julie A Rodman, Jozeph Pizzimenti, A. Saatçi

Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome is a rare spectrum of retinal vasculitis, aneurysms, and neuroretinitis affecting young individuals in their third decade. Most of our current knowledge is based on case reports, case series, and a handful of collaborative studies. There is much diversity in treatment approaches and outcomes in the reported literature. We have aggregated published case reports and case series into quantitative and narrative synthesis to draw evidence-based conclusions toward clinical features, atypical and rare findings, systemic associations, disease course, and treatment outcomes. The analysis suggested the disease mostly affects young individuals with a female predilection. Anterior chamber and vitreous inflammation are common than previously believed. The most prevalent pattern of retinal vasculitis in IRVAN eyes is mixed vasculitis, followed by arteritis and phlebitis. Most eyes at the time of presentation have capillary nonperfusion and require treatment. Most eyes retain good visual acuity; however, treatment is required to maintain visual function. Intravitreal antivascular endothelial growth factors administered as an adjunct to retinal laser photocoagulation are more likely to improve visual outcomes. Besides, we have discussed the different hypotheses on the etiopathogenesis of the disease and stronger evidence suggests an inflammatory origin of the disease.

特发性视网膜血管炎、动脉瘤和神经视网膜炎（IRVAN）综合征是一种罕见的视网膜血管炎，动脉瘤和神经元视网膜炎，影响30多岁的年轻人。我们目前的大部分知识都是基于病例报告、病例系列和少数合作研究。在报道的文献中，治疗方法和结果有很大的多样性。我们将已发表的病例报告和病例系列汇总为定量和叙述性综合，以针对临床特征、非典型和罕见发现、系统关联、病程和治疗结果得出循证结论。分析表明，这种疾病主要影响有女性偏好的年轻人。前房和玻璃体炎症比以前认为的更常见。IRVAN眼中最常见的视网膜血管炎是混合血管炎，其次是动脉炎和静脉炎。大多数眼睛在出现时都有毛细血管不融合，需要治疗。大多数眼睛保持良好的视力；然而，需要治疗来维持视觉功能。玻璃体内抗血管内皮生长因子作为视网膜激光光凝的辅助药物更有可能改善视觉效果。此外，我们还讨论了关于该疾病发病机制的不同假设，更有力的证据表明该疾病的炎症起源。

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引用次数: 5

Optical coherence tomography patterns of diabetic macular edema and treatment response to bevacizumab: a short-term study 糖尿病黄斑水肿的光学相干断层扫描模式和贝伐单抗的治疗反应:一项短期研究

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414221074519

Sadhana Sharma, P. Karki, S. N. Joshi, S. Parajuli

Background: The purpose of this study was to evaluate the short-term response of intravitreal bevacizumab in diabetic macular edema (DME) and assess the variation in treatment outcomes in different morphology patterns using spectral domain–optical coherence tomography (SD-OCT). Objective: To study different morphological patterns of DME based on OCT and compare their treatment response to bevacizumab. Methods: Hundred and twelve eyes of 112 patients with DME were included and treated with intravitreal bevacizumab (1.25 mg/0.05 ml monthly for 3 months). The morphological patterns of DME were classified on the basis of OCT into three groups – diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD) – and changes in central macular thickness (CMT) and best corrected visual acuity (BCVA) after treatment were compared. Results: A total of 112 eyes with DME were included and consisted of 40 DRT, 37 CME, and 35 SRD. Treatment with bevacizumab resulted in decrease in central macular thickness and improvement in BCVA in all three groups. The baseline visual acuity and CMT of DRT group was better than that of the other two groups. The treatment outcome was measured in terms of CMT and BCVA. Change in CMT was statistically significant among three groups and was found to be better in DRT group (p < 0.05, 95% confidence interval). However, there was statistically no significant variation between the three groups regarding the change in BCVA (p = 0.169, 95% confidence interval). Conclusion: Anatomic and visual improvement can be achieved by bevacizumab in all patterns of DME. However, individual pattern may respond differently. DRT, which appears to be the earliest form of DME, responds better than other types. Thus, the pattern of macular edema shown by OCT may provide an objective guideline in predicting the response of bevacizumab injection in DME.

背景：本研究的目的是评估玻璃体内贝伐单抗治疗糖尿病黄斑水肿（DME）的短期反应，并使用光谱域-光学相干断层扫描（SD-OCT）评估不同形态模式下治疗结果的变化。目的：基于OCT研究DME的不同形态模式，并比较其对贝伐单抗的治疗效果。方法：纳入112例DME患者的112眼，用玻璃体内贝伐单抗（1.25 mg/0.05 ml，每月3次月）。根据OCT将DME的形态学模式分为三组——弥漫性视网膜增厚（DRT）、囊状黄斑水肿（CME）和浆液性视网膜脱离（SRD）——并比较治疗后中心黄斑厚度（CMT）和最佳矫正视力（BCVA）的变化。结果：共有112眼DME患者，其中DRT 40眼，CME 37眼，SRD 35眼。贝伐单抗治疗导致三组中心黄斑厚度降低，BCVA改善。DRT组的基线视力和CMT均优于其他两组。根据CMT和BCVA测量治疗结果。CMT的变化在三组中具有统计学意义，DRT组的变化更好（p < 0.05、95%置信区间）。然而，在BCVA的变化方面，三组之间没有统计学上的显著差异（p = 0.169、95%置信区间）。结论：贝伐单抗可以改善所有类型DME的解剖和视觉。然而，个别模式可能会有不同的反应。DRT似乎是DME的最早形式，比其他类型的反应更好。因此，OCT显示的黄斑水肿模式可以为预测贝伐单抗注射液对DME的反应提供客观的指导。

{"title":"Optical coherence tomography patterns of diabetic macular edema and treatment response to bevacizumab: a short-term study","authors":"Sadhana Sharma, P. Karki, S. N. Joshi, S. Parajuli","doi":"10.1177/25158414221074519","DOIUrl":"https://doi.org/10.1177/25158414221074519","url":null,"abstract":"Background: The purpose of this study was to evaluate the short-term response of intravitreal bevacizumab in diabetic macular edema (DME) and assess the variation in treatment outcomes in different morphology patterns using spectral domain–optical coherence tomography (SD-OCT). Objective: To study different morphological patterns of DME based on OCT and compare their treatment response to bevacizumab. Methods: Hundred and twelve eyes of 112 patients with DME were included and treated with intravitreal bevacizumab (1.25 mg/0.05 ml monthly for 3 months). The morphological patterns of DME were classified on the basis of OCT into three groups – diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD) – and changes in central macular thickness (CMT) and best corrected visual acuity (BCVA) after treatment were compared. Results: A total of 112 eyes with DME were included and consisted of 40 DRT, 37 CME, and 35 SRD. Treatment with bevacizumab resulted in decrease in central macular thickness and improvement in BCVA in all three groups. The baseline visual acuity and CMT of DRT group was better than that of the other two groups. The treatment outcome was measured in terms of CMT and BCVA. Change in CMT was statistically significant among three groups and was found to be better in DRT group (p < 0.05, 95% confidence interval). However, there was statistically no significant variation between the three groups regarding the change in BCVA (p = 0.169, 95% confidence interval). Conclusion: Anatomic and visual improvement can be achieved by bevacizumab in all patterns of DME. However, individual pattern may respond differently. DRT, which appears to be the earliest form of DME, responds better than other types. Thus, the pattern of macular edema shown by OCT may provide an objective guideline in predicting the response of bevacizumab injection in DME.","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"14 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42158658","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}

引用次数: 2

Agreement in anterior segment measurements between swept-source and Scheimpflug-based optical biometries in keratoconic eyes: a pilot study 圆锥角膜的扫描源和基于Scheimpflug的光学生物测量在前段测量中的一致性：一项初步研究

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414211063283

E. Chalkiadaki, P. Gartaganis, Thomas Ntravalias, Ioannis Giannakis, E. Manousakis, Efthymios Karmiris

Background: Cataract surgery in keratoconic patients is challenging because of the corneal distortion, which can lead to inaccurate keratometry readings. This study is a comparison of the accuracy of keratometry readings by two types of devices in a tertiary hospital. Purpose: To evaluate the comparability of corneal power measurements, anterior chamber depth (ACD), and white-to-white (WTW) distance between Scheimpflug-based tomography (Pentacam AXL; OCULUS GmbH, Wetzlar, Germany) and swept-source optical biometry (IOLMaster 700; Carl Zeiss Meditec AG, Jena, Germany) in patients with keratoconus. Methods: This pilot, prospective, interinstrument reliability study included 30 keratoconic eyes of 15 individuals who had not undergone any kind of corneal surgery. Standard K and total refractive power (TK®) of the flattest and steepest axes of the IOLMaster 700 were compared with the standard keratometry (SimK), true net power (TNP), equivalent keratometer readings (EKR), and total corneal refractive power (TCRP) of the Pentacam. The Bland–Altman analysis was used to evaluate the agreement between the measurements of both devices. The paired-samples t-test and the Wilcoxon signed-rank test were performed to compare the mean values of the variables obtained with the devices. Results: The K1 value of the IOLMaster 700 was significantly higher from EKR K1 along the 3-mm (mean difference: 0.79 diopters, p = 0.01), 4-mm (mean difference: 1.01 D, p = 0.01), and 4.5-mm zones (mean difference: 1.20 D, p = 0.01) and TNP K1 along the 3-mm (mean difference: 0.88 D, p < 0.001) and 4-mm zones (mean difference: 0.97 D, p < 0.001). The TK1 value was significantly higher from EKR K1 along the 2-mm (mean difference: 0.42 D, p = 0.04), 3-mm (mean difference: 0.83 D, p = 0.003), 4-mm (mean difference: 1.05 D, p = 0.004), and 4.5-mm zones (mean difference: 1.24 D, p = 0.005) and TNP K1 along the 3-mm (mean difference: 0.92 D, p < 0.001) and 4-mm zones (mean difference: 1.01 D, p < 0.001). The K2 value of the IOLMaster 700 was significantly higher from TK2 (mean difference: 0.11 D, p = 0.04) and all the corresponding variables of the Pentacam device. The TK2 value was significantly higher from all the corresponding variables of the Pentacam device. The Pentacam also yielded significantly lower values for the WTW distance (mean difference: 0.31 mm, p < 0.001) and no significant difference in terms of ACD values (p = 0.9). Conclusion: The IOLMaster measured significantly greater keratometry readings in the steep axis for all the variables studied. The keratometry and WTW measurements of the investigated devices cannot be used interchangeably in keratoconus.

背景：圆锥角膜患者的白内障手术具有挑战性，因为角膜畸变会导致角膜测量读数不准确。这项研究比较了在三级医院使用两种类型的设备进行角膜测量的准确性。目的：评估圆锥角膜患者基于Scheimpflug的断层扫描（Pentacam AXL；OCULUS GmbH，Wetzlar，Germany）和扫描源光学生物测量（IOLMaster 700；德国耶拿卡尔蔡司Meditec AG）之间角膜屈光度测量、前房深度（ACD）和白白距离（WTW）的可比性。方法：这项试验性、前瞻性、仪器间可靠性研究包括15名未接受任何角膜手术的患者的30只圆锥角膜眼。IOLMaster 700最平和最陡轴的标准K和总屈光力（TK®）与Pentacam的标准角膜曲率计（SimK）、真实净屈光力（TNP）、等效角膜曲率计读数（EKR）和总角膜屈光力（TCRP）进行了比较。Bland–Altman分析用于评估两种设备的测量结果之间的一致性。进行配对样本t检验和Wilcoxon符号秩检验，以比较使用设备获得的变量的平均值。结果：IOLMaster 700的K1值沿3毫米方向明显高于EKR K1（平均差异：0.79屈光度，p = 0.01），4mm（平均差异：1.01D，p = 0.01）和4.5毫米区域（平均差异：1.20 D，p = 0.01）和TNP K1（平均差值：0.88 D，p＜0.001）。TK1值显著高于EKR K1（平均差别：0.42 D，p＞0.001） = 0.04），3毫米（平均差值：0.83 D，p = 0.003），4mm（平均差值：1.05 D，p = 0.004）和4.5毫米区域（平均差异：1.24 D，p = 0.005）和TNP K1（平均差异：0.92D，p＜0.001） = 0.04）和Pentacam装置的所有相应变量。TK2值明显高于Pentacam装置的所有相应变量。Pentacam的WTW距离值也显著较低（平均差异：0.31 mm，p<0.001），ACD值没有显著差异（p = 0.9）。结论：IOLMaster在所有研究变量的陡峭轴上测量到明显更大的角膜曲率读数。所研究装置的角膜测量和WTW测量不能在圆锥角膜中互换使用。

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引用次数: 5

Combined photorefractive keratectomy and corneal collagen cross-linking for treatment of keratoconus: a 2-year follow-up study 联合光屈光性角膜切除术和角膜胶原交联治疗圆锥角膜:一项2年随访研究

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414221083362

G. De Rosa, S. Rossi, Carmine Santamaria, Rosa Boccia, L. de Rosa, Francesco Maria D’Alterio, F. Simonelli

Background: Corneal collagen cross-linking (CXL) is considered an effective procedure for slowing down or eliminating the progression of keratoconus. New techniques, in combination with CXL, have been proposed to stop the evolution of keratoconus and improve the visual function. Objective: To evaluate the effectiveness of combined photorefractive keratectomy (PRK) with mitomycin-C (MMC) application and CXL in the management of grade 1–2 keratoconus over a 2-year follow-up. Methods: Fifteen eyes underwent topography-guided PRK with 0.02% MMC application immediately followed by standard CXL. Results: Best corrected visual acuity improved from 0.15 ± 0.11 logMAR to 0.08 ± 0.09 logMAR at 24 months (p < 0.0001) in treated eyes. Mean steepest meridian keratometry reduced from 48.79 ± 3.22 D at baseline to 46.16 ± 3.11 D at 24 months (p < 0.0001). Mean flattest meridian keratometry reduced from 45.18 ± 2.17 D preoperatively to 44.35 ± 2.19 D at 24 months (p < 0.0001). Conclusion: Simultaneous topography-guided PRK with MMC 0.02% application and standard CXL is a safe, promising and effective procedure in the treatment of mild and moderate keratoconus.

背景:角膜胶原交联(CXL)被认为是减缓或消除圆锥角膜进展的有效方法。新的技术，结合CXL，已被提出，以阻止圆锥角膜的进化和改善视觉功能。目的:评价光屈光性角膜切除术(PRK)联合丝裂霉素- c (MMC)和CXL治疗1-2级圆锥角膜的疗效。方法:15只眼行地形引导PRK，应用0.02% MMC后立即行标准CXL。结果:治疗眼24月最佳矫正视力由0.15±0.11 logMAR改善至0.08±0.09 logMAR (p < 0.0001)。平均最陡子午角度数从基线时的48.79±3.22 D降至24个月时的46.16±3.11 D (p < 0.0001)。平均平直子午角度数由术前的45.18±2.17 D降至24个月时的44.35±2.19 D (p < 0.0001)。结论:地形引导PRK同时应用0.02% MMC和标准CXL治疗轻中度圆锥角膜是一种安全、有前景、有效的手术方法。

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引用次数: 2

A comprehensive review of intravitreal immunosuppressants and biologicals used in ophthalmology 眼科玻璃体内免疫抑制剂和生物制剂的综合综述

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414221097418

Nasiq Hasan, R. Chawla, Nawazish Shaikh, Sindhuja Kandasamy, S. Azad, M. Sundar

Systemic immunosuppressants and biologicals have been a valuable tool in the treatment of inflammatory diseases and malignancies. The safety profile of these drugs has been debatable, especially in localized systems, such as the eye. This has led to the search for fairly local approaches, such as intravitreal, subconjunctival, and topical route of administration. Immunosuppressants have been used as a second-line drug in patients intolerable to corticosteroids or those who develop multiple recurrences on weaning corticosteroids. Similarly, biologicals have also been used as the next line of therapy, when adequate control of inflammation could not be attained or immunosuppressants were contraindicated to patients. Intravitreal immunosuppressants, such as methotrexate and sirolimus, have been extensively studied in noninfectious posterior uveitis, whereas limited studies have established the efficacy of intravitreal biologicals, such as infliximab and adalimumab. Most of these drugs have shown good safety profile and tolerability in animal studies alone and have not been studied further in human subjects. However, most of the studies in literature are single-case reports or case series which limits the level of evidence. In this comprehensive review, we discuss the mechanism of action, pharmacodynamics, pharmacokinetics, indications, efficacy, and side effects of different intravitreal immunosuppressants and biologicals that have been studied in literature.

系统性免疫抑制剂和生物制剂已成为治疗炎症性疾病和恶性肿瘤的宝贵工具。这些药物的安全性一直存在争议，尤其是在眼部等局部系统中。这导致了寻找相当局部的方法，如玻璃体内、结膜下和局部给药途径。免疫抑制剂已被用作皮质类固醇不能耐受的患者或断奶后出现多发复发的患者的二线药物。同样，当无法充分控制炎症或患者禁用免疫抑制剂时，生物制剂也被用作下一种治疗方法。玻璃体内免疫抑制剂，如甲氨蝶呤和西罗莫司，已在非感染性后葡萄膜炎中进行了广泛研究，而有限的研究已确定玻璃体内生物制剂的疗效，如英夫利昔单抗和阿达木单抗。这些药物中的大多数在单独的动物研究中显示出良好的安全性和耐受性，尚未在人类受试者中进行进一步研究。然而，文献中的大多数研究都是单一的病例报告或病例系列，这限制了证据的水平。在这篇全面的综述中，我们讨论了文献中研究的不同玻璃体内免疫抑制剂和生物制品的作用机制、药效学、药代动力学、适应症、疗效和副作用。

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引用次数: 4

The prevalence of anxiety symptoms and disorders among ophthalmic disease patients. 眼病患者焦虑症状和障碍的患病率。

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414221090100

Zulvikar Syambani Ulhaq, Gita Vita Soraya, Nadia Artha Dewi, Lely Retno Wulandari

Background: Progressive and irreversible vision loss has been shown to place a patient at risk of mental health problems such as anxiety. However, the reported prevalence of anxiety symptoms and disorders among eye disease patients vary across studies. Thus, this study aims to clarify the estimated prevalence of anxiety symptoms and disorders among ophthalmic disease patients.

Methods: Relevant studies on the prevalence of anxiety symptoms and disorders among eye disease patients were collected through international databases, PubMed, Scopus, and Web of Science. A random-effects model was used to determine the pooled prevalence of anxiety symptoms and disorders among ophthalmic disease patients.

Results: The 95 included studies yielded a pooled prevalence of 31.2% patients with anxiety symptoms and 19.0% with anxiety disorders among subjects with ophthalmic disease. Pediatric patients were more anxious (58.6%) than adults (29%). Anxiety symptoms were most prevalent in uveitis (53.5%), followed by dry eye disease (DED, 37.2%), retinitis pigmentosa (RP, 36.5%), diabetic retinopathy (DR, 31.3%), glaucoma (30.7%), myopia (24.7%), age-related macular degeneration (AMD, 21.6%), and cataract (21.2%) patients. Anxiety disorders were most prevalent in thyroid eye disease (TED, 28.9%), followed by glaucoma (22.2%) and DED (11.4%). When compared with healthy controls, there was a twofold increase on the prevalence of anxiety symptoms (OR = 1.912, 95% CI 1.463-2.5, p < 0.001) and anxiety disorders (OR = 2.281, 95% CI 1.168-4.454, p = 0.016).

Conclusion: Anxiety symptoms and disorders are common problems associated with ophthalmic disease patients. Thus, comprehensive and appropriate treatments are necessary for treating anxiety symptoms and disorders among ophthalmic disease patients.

背景:进行性和不可逆转的视力丧失已被证明会使患者面临焦虑等心理健康问题的风险。然而，在不同的研究中，眼病患者中焦虑症状和疾病的患病率有所不同。因此，本研究旨在厘清眼病患者焦虑症状和障碍的估计患病率。方法:通过国际数据库、PubMed、Scopus和Web of Science收集眼病患者焦虑症状和障碍患病率的相关研究。采用随机效应模型确定眼病患者焦虑症状和障碍的总患病率。结果:纳入的95项研究显示，眼部疾病患者中有焦虑症状的患者占31.2%，有焦虑障碍的患者占19.0%。儿科患者的焦虑程度(58.6%)高于成人(29%)。焦虑症状在葡萄膜炎患者中最为普遍(53.5%)，其次是干眼病(DED, 37.2%)、色素性视网膜炎(RP, 36.5%)、糖尿病性视网膜病变(DR, 31.3%)、青光眼(30.7%)、近视(24.7%)、年龄相关性黄斑变性(AMD, 21.6%)和白内障(21.2%)。焦虑障碍在甲状腺眼病中最常见(TED, 28.9%)，其次是青光眼(22.2%)和DED(11.4%)。与健康对照组相比，焦虑症状的患病率增加了两倍(OR = 1.912, 95% CI 1.463-2.5, p p = 0.016)。结论:焦虑症状和障碍是眼病患者的常见问题。因此，对眼病患者的焦虑症状和障碍进行全面、适当的治疗是必要的。

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引用次数: 4

Comment on 'Assessment of corneal endothelial cell morphology and anterior segment parameters in COVID-19'. 对“COVID-19角膜内皮细胞形态学和前段参数的评估”的评论。

IF 2.5 Q2 OPHTHALMOLOGY

Therapeutic Advances in Ophthalmology

Pub Date : 2022-01-01 DOI: 10.1177/25158414221138204

Nurettin Bayram

a result of various protuberances on the endothelium, such as dead endothelial cells or cellular debris

引用次数: 0