Pub Date : 2022-03-04DOI: 10.1080/17469899.2022.2085557
I. Toprak, D. Kılıç
ABSTRACT Introduction Due to structural differences between pediatric and adult corneas, keratoconus (KC) is considered more aggressive in pediatrics than in adults. It is controversial whether therapeutic intervention in pediatric KC should differ from adult KC. Areas covered We investigate if there is a substantial difference between pediatric and adult KC regarding disease severity and progression rate, factors important for treatment timing and prognosis. Then, feasibility of current treatment modalities is discussed based on current evidence. Expert opinion Despite several conflicting reports, pediatric KC is more severe at initial diagnosis with faster progression. Progression can be tracked in a variety of ways, including with the Belin ABCD progression system. Controlling ocular allergy and eye rubbing is the first step in treatment. The epithelium-off Dresden protocol remains the gold standard CXL approach to stop progression in pediatric KC, whereas epithelium-off accelerated CXL might be an alternative. In pediatric patients, both penetrating and lamellar keratoplasty can be challenging; however, lamellar keratoplasty seems to offer the advantage of lower graft rejection rate. Epithelium-on CXL, intracorneal ring segment implantation, excimer laser ablation + CXL protocols are not recommended in pediatric KC. Nevertheless, there remains a need for evidence-based clinical practical guidelines in pediatric KC.
{"title":"Current clinical approach to pediatric keratoconus patients","authors":"I. Toprak, D. Kılıç","doi":"10.1080/17469899.2022.2085557","DOIUrl":"https://doi.org/10.1080/17469899.2022.2085557","url":null,"abstract":"ABSTRACT Introduction Due to structural differences between pediatric and adult corneas, keratoconus (KC) is considered more aggressive in pediatrics than in adults. It is controversial whether therapeutic intervention in pediatric KC should differ from adult KC. Areas covered We investigate if there is a substantial difference between pediatric and adult KC regarding disease severity and progression rate, factors important for treatment timing and prognosis. Then, feasibility of current treatment modalities is discussed based on current evidence. Expert opinion Despite several conflicting reports, pediatric KC is more severe at initial diagnosis with faster progression. Progression can be tracked in a variety of ways, including with the Belin ABCD progression system. Controlling ocular allergy and eye rubbing is the first step in treatment. The epithelium-off Dresden protocol remains the gold standard CXL approach to stop progression in pediatric KC, whereas epithelium-off accelerated CXL might be an alternative. In pediatric patients, both penetrating and lamellar keratoplasty can be challenging; however, lamellar keratoplasty seems to offer the advantage of lower graft rejection rate. Epithelium-on CXL, intracorneal ring segment implantation, excimer laser ablation + CXL protocols are not recommended in pediatric KC. Nevertheless, there remains a need for evidence-based clinical practical guidelines in pediatric KC.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45319260","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 : 2022-03-04DOI: 10.1080/17469899.2022.2060821
E. Papageorgiou, Katerina Lazari, I. Gottlob
ABSTRACT Introduction Developmental abnormalities of the optic nerve (ON) and pediatric optic neuropathies, such as glaucoma, are leading causes of childhood blindness. The recent development of hand-held spectral domain optical coherence tomography (HH-OCT) has enabled noncontact, high-resolution scanning in non-sedated newborns, infants, and young children and has provided for the first time, in vivo visualization of the retina and ON in these patient groups. Areas covered This review will address the applications, recent advances, and future potential of HH-OCT in diagnosis and monitoring of pediatric optic neuropathies. We will provide an update on the use of HH-OCT in pediatric glaucoma, congenital optic disc anomalies, optic pathway gliomas, optic atrophy, and papilledema. Expert opinion HH-OCT could offer particular utility in children with optic neuropathies, by providing noninvasive, high-resolution characterization of the optic nerve head. Optic nerve parameters, such as retinal nerve fiber layer thickness, could serve as biomarkers to assess the severity of optic nerve disease qualitatively and quantitatively. Hence, HH-OCT is emerging as a powerful imaging tool to facilitate early diagnosis, identify prognostic biomarkers, monitor disease progression, and assess response to treatment.
{"title":"Hand-held optical coherence tomography: advancements in detection and assessment of optic nerve abnormalities and disease progression monitoring","authors":"E. Papageorgiou, Katerina Lazari, I. Gottlob","doi":"10.1080/17469899.2022.2060821","DOIUrl":"https://doi.org/10.1080/17469899.2022.2060821","url":null,"abstract":"ABSTRACT Introduction Developmental abnormalities of the optic nerve (ON) and pediatric optic neuropathies, such as glaucoma, are leading causes of childhood blindness. The recent development of hand-held spectral domain optical coherence tomography (HH-OCT) has enabled noncontact, high-resolution scanning in non-sedated newborns, infants, and young children and has provided for the first time, in vivo visualization of the retina and ON in these patient groups. Areas covered This review will address the applications, recent advances, and future potential of HH-OCT in diagnosis and monitoring of pediatric optic neuropathies. We will provide an update on the use of HH-OCT in pediatric glaucoma, congenital optic disc anomalies, optic pathway gliomas, optic atrophy, and papilledema. Expert opinion HH-OCT could offer particular utility in children with optic neuropathies, by providing noninvasive, high-resolution characterization of the optic nerve head. Optic nerve parameters, such as retinal nerve fiber layer thickness, could serve as biomarkers to assess the severity of optic nerve disease qualitatively and quantitatively. Hence, HH-OCT is emerging as a powerful imaging tool to facilitate early diagnosis, identify prognostic biomarkers, monitor disease progression, and assess response to treatment.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41538272","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 : 2022-03-04DOI: 10.1080/17469899.2022.2085558
Wipada Sae-Lao, Kansuda Wunjuntuk, T. Techakriengkrai, P. Sirichakwal, S. Yaisawang, Sukanya Kom-on
ABSTRACT Background The aim of this study was to determine macular pigment optical density (MPOD) and identify factors that correlate with its level in Thai subjects. Research design and methods This research was a cross-sectional study. Two hundred and forty eyes of 120 participants with healthy eyes underwent MPOD measurement using VISUCAM 500. Demographic and medical data were collected. Pearson’s correlation coefficient analyzed the relationship between the sum of optical densities (MPOD volume) and various factors. MPOD and its influencing factors were analyzed by stepwise multiple regression. Results The mean age of the participants was 50.7 ± 7.5 years. The mean MPOD was 0.102 ± 0.023 density units. The factors age (r = 0.261, p < 0.01), female gender (r = 0.191, p < 0.05), and consumption of lutein and zeaxanthin (L/Z) supplement (r = 0.168, p < 0.05) were positively associated with MPOD volume. In contrast, normal blood pressure (r = – 0.182, p < 0.05) was negatively associated with MPOD volume. No relationship with smoking, body mass index, lipid profile, and family history of AMD on MPOD values was observed in this study. Conclusions Age, gender and consumption of L/Z supplement were found to be significant predictors of MPOD in Thai subjects.
{"title":"Macular pigment optical density in a Thai sample","authors":"Wipada Sae-Lao, Kansuda Wunjuntuk, T. Techakriengkrai, P. Sirichakwal, S. Yaisawang, Sukanya Kom-on","doi":"10.1080/17469899.2022.2085558","DOIUrl":"https://doi.org/10.1080/17469899.2022.2085558","url":null,"abstract":"ABSTRACT Background The aim of this study was to determine macular pigment optical density (MPOD) and identify factors that correlate with its level in Thai subjects. Research design and methods This research was a cross-sectional study. Two hundred and forty eyes of 120 participants with healthy eyes underwent MPOD measurement using VISUCAM 500. Demographic and medical data were collected. Pearson’s correlation coefficient analyzed the relationship between the sum of optical densities (MPOD volume) and various factors. MPOD and its influencing factors were analyzed by stepwise multiple regression. Results The mean age of the participants was 50.7 ± 7.5 years. The mean MPOD was 0.102 ± 0.023 density units. The factors age (r = 0.261, p < 0.01), female gender (r = 0.191, p < 0.05), and consumption of lutein and zeaxanthin (L/Z) supplement (r = 0.168, p < 0.05) were positively associated with MPOD volume. In contrast, normal blood pressure (r = – 0.182, p < 0.05) was negatively associated with MPOD volume. No relationship with smoking, body mass index, lipid profile, and family history of AMD on MPOD values was observed in this study. Conclusions Age, gender and consumption of L/Z supplement were found to be significant predictors of MPOD in Thai subjects.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47356160","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 : 2022-03-04DOI: 10.1080/17469899.2022.2084073
R. Schwartz, Nicola Cronbach, H. Madi, R. Reynolds, U. Chakravarthy
Optical coherence tomography angiography (OCTA) is a relatively new imaging modality that allows visualization of the retinal and choroidal vasculature. While this has traditionally only been possible through dye-based imaging techniques (fluorescein angiography (FA) and indocyanine green angiography (ICG)), OCTA offers a fast and noninvasive alternative that is readily repeatable and can be used to image the retinal and choroidal vasculature in a single scan without the need for dye injection. Another advantage of OCTA is its ability to produce depthresolved evaluation of the reflectance data from retinal tissue, providing a three-dimensional volume of information. The retinal and choroidal capillary networks are arranged into morphologically distinct layers, from the superficial capillary plexus to the choroid. In the case of neovascular age-related macular degeneration (nAMD), this enables the clinician to determine whether a neovascular network is present, its relative position within the retina/choroid and, with the use of repeated OCTA scans over multiple visits, whether this network is changing. However, there is currently no single standard for acquisition or interpretation of OCTA data. The first commercial OCTA machine (AngioVue, Optovue, Fremont, CA) was introduced in 2014 and was based on spectral domain OCT (SD-OCT). Subsequent OCTA devices have been based on either SD-OCT or swept source OCT (SS-OCT). SD-OCT and SS-OCT are both types of Fourier domain OCT but differ in their light source, wavelength, and photodetector, which results in differences in scanning speeds and resolution of imaging at the various levels within the retina and choroid. The longer wavelength of SS-OCT (~1050 nm, vs ~840 nm for SD-OCT) and reduced sensitivity rolloff enables acquisition of high-resolution OCTA imaging particularly of neovascular networks below the retinal pigment epithelium compared with SD-OCT scanning. The quicker scanning speeds of SS-OCT also allow for a larger area to be imaged. However, different devices utilize different algorithms to process and segment the data acquired, and therefore there are differences in the images produced. Continuous advances in OCTA technology and improvements in the quality of images produced have led to increasing use of OCTA globally for clinical purposes, particularly for the diagnosis and monitoring of macular neovascularization [1]. In this article, we discuss the role of OCTA in nAMD and how it can be of use to clinicians in the diagnosis and management of nAMD.
{"title":"The utility of optical coherence tomography angiography in the management of neovascular age-related macular degeneration – current perspective","authors":"R. Schwartz, Nicola Cronbach, H. Madi, R. Reynolds, U. Chakravarthy","doi":"10.1080/17469899.2022.2084073","DOIUrl":"https://doi.org/10.1080/17469899.2022.2084073","url":null,"abstract":"Optical coherence tomography angiography (OCTA) is a relatively new imaging modality that allows visualization of the retinal and choroidal vasculature. While this has traditionally only been possible through dye-based imaging techniques (fluorescein angiography (FA) and indocyanine green angiography (ICG)), OCTA offers a fast and noninvasive alternative that is readily repeatable and can be used to image the retinal and choroidal vasculature in a single scan without the need for dye injection. Another advantage of OCTA is its ability to produce depthresolved evaluation of the reflectance data from retinal tissue, providing a three-dimensional volume of information. The retinal and choroidal capillary networks are arranged into morphologically distinct layers, from the superficial capillary plexus to the choroid. In the case of neovascular age-related macular degeneration (nAMD), this enables the clinician to determine whether a neovascular network is present, its relative position within the retina/choroid and, with the use of repeated OCTA scans over multiple visits, whether this network is changing. However, there is currently no single standard for acquisition or interpretation of OCTA data. The first commercial OCTA machine (AngioVue, Optovue, Fremont, CA) was introduced in 2014 and was based on spectral domain OCT (SD-OCT). Subsequent OCTA devices have been based on either SD-OCT or swept source OCT (SS-OCT). SD-OCT and SS-OCT are both types of Fourier domain OCT but differ in their light source, wavelength, and photodetector, which results in differences in scanning speeds and resolution of imaging at the various levels within the retina and choroid. The longer wavelength of SS-OCT (~1050 nm, vs ~840 nm for SD-OCT) and reduced sensitivity rolloff enables acquisition of high-resolution OCTA imaging particularly of neovascular networks below the retinal pigment epithelium compared with SD-OCT scanning. The quicker scanning speeds of SS-OCT also allow for a larger area to be imaged. However, different devices utilize different algorithms to process and segment the data acquired, and therefore there are differences in the images produced. Continuous advances in OCTA technology and improvements in the quality of images produced have led to increasing use of OCTA globally for clinical purposes, particularly for the diagnosis and monitoring of macular neovascularization [1]. In this article, we discuss the role of OCTA in nAMD and how it can be of use to clinicians in the diagnosis and management of nAMD.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49363650","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 : 2022-03-04DOI: 10.1080/17469899.2022.2065984
Z. Corrêa
ABSTRACT Introduction Sampling of uveal tumors using fine-needle aspiration biopsy (FNAB) or vitrectomy cutter choroidal biopsy (VCCB) has become part of the standard of care in diagnosis and prognosis of uveal melanomas and borderline melanocytic uveal tumors. For early adopters, the use of FNAB (or VCCB) has shown that benefits of tumor sampling far outweigh the risks, particularly with respect to the ability to confirm tumor diagnostic and prognostic testing. Areas covered This manuscript will review the different techniques used to obtain small samples of uveal tumors with minimal disruption of the ocular tissues, briefly discuss clinical applications and complications of FNAB and VCCB, and ways in which to improve specimen yield and patient outcomes. Expert opinion The published literature shows a lack of uniformity in indication and surgical techniques among ocular oncologists performing FNAB and VCCB. This fact can potentially lead to discrepant results that include variable rates of success in obtaining a sufficient specimen and a wide range of complications, from intraocular hemorrhage, retinal detachment to anecdotal cases of seeding of the biopsy needle track and extraocular tumor extension. Uniform indications and surgical techniques would allow comparison among different centers and protocols to minimize and manage complications.
{"title":"Uveal melanoma: clinical management of ocular complications after tumor biopsy","authors":"Z. Corrêa","doi":"10.1080/17469899.2022.2065984","DOIUrl":"https://doi.org/10.1080/17469899.2022.2065984","url":null,"abstract":"ABSTRACT Introduction Sampling of uveal tumors using fine-needle aspiration biopsy (FNAB) or vitrectomy cutter choroidal biopsy (VCCB) has become part of the standard of care in diagnosis and prognosis of uveal melanomas and borderline melanocytic uveal tumors. For early adopters, the use of FNAB (or VCCB) has shown that benefits of tumor sampling far outweigh the risks, particularly with respect to the ability to confirm tumor diagnostic and prognostic testing. Areas covered This manuscript will review the different techniques used to obtain small samples of uveal tumors with minimal disruption of the ocular tissues, briefly discuss clinical applications and complications of FNAB and VCCB, and ways in which to improve specimen yield and patient outcomes. Expert opinion The published literature shows a lack of uniformity in indication and surgical techniques among ocular oncologists performing FNAB and VCCB. This fact can potentially lead to discrepant results that include variable rates of success in obtaining a sufficient specimen and a wide range of complications, from intraocular hemorrhage, retinal detachment to anecdotal cases of seeding of the biopsy needle track and extraocular tumor extension. Uniform indications and surgical techniques would allow comparison among different centers and protocols to minimize and manage complications.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44037896","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 : 2022-03-04DOI: 10.1080/17469899.2022.2066523
Bita Momenaei, Kasra Cheraqpour, M. Soleimani, S. Tabatabaei, M. Shahriari, Hamed Etesali, Ahmed Hussein, Yasaman Vaseghi, Bahareh Ramezani, A. Djalilian
ABSTRACT Introduction The COVID-19 pandemic has been a rapidly emerging global health concern since December 2019. Unprecedented efforts have been made to produce vaccines, which have proven to be successful. Areas covered This is a narrative review of the known ocular side effects related to the COVID-19 vaccines. Relevant literature was identified up to January 2022. Herein, reports of several side effects after immunization with COVID-19 vaccines, such as corneal graft rejection, ocular herpes simplex virus reactivation, scleritis, anterior and intermediate uveitis, multiple evanescent white dot syndrome, acute zonal occult outer retinopathy, panuveitis, multifocal choroiditis, toxoplasma retinochoroiditis, central serous retinopathy, branch/central retinal vein occlusion, paracentral acute middle maculopathy, arteritic anterior ischemic optic neuropathy, optic neuritis, third nerve palsy, superior ophthalmic vein thrombosis, and Tolosa–Hunt syndrome, are reviewed and presented. Expert opinion Our knowledge regarding vaccination-related adverse events during the COVID-19 pandemic is growing. Ocular side effects are very rare overall and can often be treatable and preventable. Vaccinations remain strongly recommended by experts due to their efficacy in decreasing the disease burden. It is of note that establishing a casual relationship between vaccines and side effects is not possible yet and the possibility of coincidence should be considered.
{"title":"Ophthalmic side effects of COVID-19 vaccines","authors":"Bita Momenaei, Kasra Cheraqpour, M. Soleimani, S. Tabatabaei, M. Shahriari, Hamed Etesali, Ahmed Hussein, Yasaman Vaseghi, Bahareh Ramezani, A. Djalilian","doi":"10.1080/17469899.2022.2066523","DOIUrl":"https://doi.org/10.1080/17469899.2022.2066523","url":null,"abstract":"ABSTRACT Introduction The COVID-19 pandemic has been a rapidly emerging global health concern since December 2019. Unprecedented efforts have been made to produce vaccines, which have proven to be successful. Areas covered This is a narrative review of the known ocular side effects related to the COVID-19 vaccines. Relevant literature was identified up to January 2022. Herein, reports of several side effects after immunization with COVID-19 vaccines, such as corneal graft rejection, ocular herpes simplex virus reactivation, scleritis, anterior and intermediate uveitis, multiple evanescent white dot syndrome, acute zonal occult outer retinopathy, panuveitis, multifocal choroiditis, toxoplasma retinochoroiditis, central serous retinopathy, branch/central retinal vein occlusion, paracentral acute middle maculopathy, arteritic anterior ischemic optic neuropathy, optic neuritis, third nerve palsy, superior ophthalmic vein thrombosis, and Tolosa–Hunt syndrome, are reviewed and presented. Expert opinion Our knowledge regarding vaccination-related adverse events during the COVID-19 pandemic is growing. Ocular side effects are very rare overall and can often be treatable and preventable. Vaccinations remain strongly recommended by experts due to their efficacy in decreasing the disease burden. It is of note that establishing a casual relationship between vaccines and side effects is not possible yet and the possibility of coincidence should be considered.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45765987","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 : 2022-02-07DOI: 10.1080/17469899.2022.2039629
P. Patel, Rhea Gopali, Anvith Reddy, Kajol K. Patel
ABSTRACT Background To analyze the incidence of baseball-related ocular injuries, mechanisms commonly associated with precipitating trauma, and secondary visual sequelae, and explore the age and sex-specific variations in the distributions of these variables. Methods Baseball-related ocular injuries presenting to the emergency department (ED) were identified using the National Electronic Injury Surveillance System for 2011 through 2020. Age, sex, diagnosis, mechanism of injury, visual sequela, and patient disposition were analyzed. Statistical comparisons were performed using the chi-square test and Fisher exact test. Results 558 ED presentations were captured, translating to an average national incidence of 1,492 events. The incidence of trauma declined notably. Most encounters involved pediatric (≤18) and male patients (82.6% and 87.6%, respectively). Patients commonly presented with contusions or abrasions (41.4%). Contact with the baseball was the most frequently mentioned mechanism of injury (87.6%). There was a significant age-related (P = 0.009) difference in the distributions of diagnoses. 7.3% of patients had a visual sequela. Conclusions There was a declining incidence of baseball-related ocular injuries presenting to the ED. However, the long-term complications of injuries could not be explored. Further efforts are required to understand the implications of ocular injuries to ensure patients receive appropriate protections.
{"title":"Baseball-related ocular injuries in the United States: a 10-year analysis","authors":"P. Patel, Rhea Gopali, Anvith Reddy, Kajol K. Patel","doi":"10.1080/17469899.2022.2039629","DOIUrl":"https://doi.org/10.1080/17469899.2022.2039629","url":null,"abstract":"ABSTRACT Background To analyze the incidence of baseball-related ocular injuries, mechanisms commonly associated with precipitating trauma, and secondary visual sequelae, and explore the age and sex-specific variations in the distributions of these variables. Methods Baseball-related ocular injuries presenting to the emergency department (ED) were identified using the National Electronic Injury Surveillance System for 2011 through 2020. Age, sex, diagnosis, mechanism of injury, visual sequela, and patient disposition were analyzed. Statistical comparisons were performed using the chi-square test and Fisher exact test. Results 558 ED presentations were captured, translating to an average national incidence of 1,492 events. The incidence of trauma declined notably. Most encounters involved pediatric (≤18) and male patients (82.6% and 87.6%, respectively). Patients commonly presented with contusions or abrasions (41.4%). Contact with the baseball was the most frequently mentioned mechanism of injury (87.6%). There was a significant age-related (P = 0.009) difference in the distributions of diagnoses. 7.3% of patients had a visual sequela. Conclusions There was a declining incidence of baseball-related ocular injuries presenting to the ED. However, the long-term complications of injuries could not be explored. Further efforts are required to understand the implications of ocular injuries to ensure patients receive appropriate protections.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45822100","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 : 2022-01-02DOI: 10.1080/17469899.2022.2045951
T. Caporossi, M. Ripa, Lorenzo Governatori, Alessandra Scampoli, G. Gambini, Clara Rizzo, Raphael Kilian, S. Rizzo
ABSTRACT Introduction Despite the great advancements in full-thickness macular hole (FTMH)-surgery that we have witnessed in the last decade, refractory FTMHs still occur. Areas covered Refractory FTMHs may result from the clinical characteristics and conformation of the hole, or from poor intraoperative and postoperative management. Failure of pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling represents a challenge for vitreoretinal surgeons, and the continuous proposal of new surgical techniques expresses the ongoing need for the optimal treatment of macular holes. We review the current management and surgical techniques for refractory macular holes, highlighting evidence from recent studies. Expert opinion Surgical techniques continue to improve in order to satisfy the demands for the best management of refractory macular holes.
{"title":"The current surgical management of refractory full-thickness macular holes","authors":"T. Caporossi, M. Ripa, Lorenzo Governatori, Alessandra Scampoli, G. Gambini, Clara Rizzo, Raphael Kilian, S. Rizzo","doi":"10.1080/17469899.2022.2045951","DOIUrl":"https://doi.org/10.1080/17469899.2022.2045951","url":null,"abstract":"ABSTRACT Introduction Despite the great advancements in full-thickness macular hole (FTMH)-surgery that we have witnessed in the last decade, refractory FTMHs still occur. Areas covered Refractory FTMHs may result from the clinical characteristics and conformation of the hole, or from poor intraoperative and postoperative management. Failure of pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling represents a challenge for vitreoretinal surgeons, and the continuous proposal of new surgical techniques expresses the ongoing need for the optimal treatment of macular holes. We review the current management and surgical techniques for refractory macular holes, highlighting evidence from recent studies. Expert opinion Surgical techniques continue to improve in order to satisfy the demands for the best management of refractory macular holes.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43969529","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 : 2022-01-02DOI: 10.1080/17469899.2022.2026217
Nisa Silva, J. Bollemeijer, André Ferreira, M. Menéres, H. Lemij
ABSTRACT Introduction Glaucoma drainage devices (GDD) have become very popular in the surgical management of patients with glaucoma. Areas covered One of the important steps in GDD surgery is the tube coverage, in order to avoid the occurrence of postoperative tube exposure which carries the risk of infectious endophthalmitis. Several patch graft materials or autologous scleral procedures have been proposed, of which the donor scleral graft, pericardial graft, and scleral flap are among the most frequently adopted. We aimed to provide a comprehensive review of the literature on this topic, with a focus on the material and characteristics, surgical technique, and advantages and disadvantages of each of these three common options. Expert opinion Both donor scleral grafts and scleral flaps provide a low and similar rate of postoperative tube exposure and low costs. The scleral flap procedure is readily available but may carry the risk of intraoperative complications and corneal issues related to scleral biomechanical changes. Pericardial grafts are associated with higher rates of graft thinning and tube exposure.
{"title":"Donor scleral graft vs pericardial graft vs scleral flap in tube drainage covering: advantages and disadvantages","authors":"Nisa Silva, J. Bollemeijer, André Ferreira, M. Menéres, H. Lemij","doi":"10.1080/17469899.2022.2026217","DOIUrl":"https://doi.org/10.1080/17469899.2022.2026217","url":null,"abstract":"ABSTRACT Introduction Glaucoma drainage devices (GDD) have become very popular in the surgical management of patients with glaucoma. Areas covered One of the important steps in GDD surgery is the tube coverage, in order to avoid the occurrence of postoperative tube exposure which carries the risk of infectious endophthalmitis. Several patch graft materials or autologous scleral procedures have been proposed, of which the donor scleral graft, pericardial graft, and scleral flap are among the most frequently adopted. We aimed to provide a comprehensive review of the literature on this topic, with a focus on the material and characteristics, surgical technique, and advantages and disadvantages of each of these three common options. Expert opinion Both donor scleral grafts and scleral flaps provide a low and similar rate of postoperative tube exposure and low costs. The scleral flap procedure is readily available but may carry the risk of intraoperative complications and corneal issues related to scleral biomechanical changes. Pericardial grafts are associated with higher rates of graft thinning and tube exposure.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47180994","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 : 2022-01-02DOI: 10.1080/17469899.2022.2030709
A. Markan, S. Neupane, R. Agrawal, Vishali Gupta
ABSTRACT Introduction Last few decades in medical retina have encountered significant development in the field of pharmacotherapy. With better understanding of molecular mechanisms and disease pathophysiology, alternate pathways are being targeted in various clinical trials. Areas covered In this review, a comprehensive list of newer therapeutic agents in various retinal conditions like diabetic macular edema (DME), age-related macular degeneration (ARMD), inherited retinal diseases (IRDs) and non-arteritic ischemic optic neuropathy (NAION) have been elucidated. The review highlights alternate pathways involved in pathogenesis of DME and ARMD, and gives a brief summary of several phase I and phase II trials targeting these pathways. The review also briefly highlights the advancements in the field of gene therapy, stem cell transplantation, neuro-protection and retinal implants in IRDs. Lastly, available treatment options for NAION have been discussed. Expert opinion Evidence based medicine has allowed researches and vision scientists to explore newer drugs and target alternate disease pathways. Promising results with initial clinical trials will pave the pathway for larger studies and allow clinicians to overcome treatment burden presently associated with available treatment options.
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