Pub Date : 2023-07-04DOI: 10.1080/17469899.2023.2255746
S. Handa, Hind Amin, Atul Arora, R. Agrawal, Vishali Gupta
ABSTRACT Introduction Ocular tuberculosis (OTB) is a significant cause of visual morbidity and can have varied clinical manifestations. Recent advances in imaging and molecular diagnostic methods have greatly improved our understanding of the disease process. We conducted a search of published articles related to the diagnosis of ocular tuberculosis as of December 2021. Keywords were used to search the databases. Databases that were searched included PubMed and Scopus. Areas covered This review highlights the role of novel imaging modalities including ultra-widefield fundus photography, widefield fluorescein angiography, widefield indocyanine green angiography, swept-source optical coherence tomography, and optical coherence tomography angiography in the diagnosis of OTB. Radiological, immunological, and molecular diagnostic methods and their role in diagnosis of OTB have been discussed as well. Expert opinion With recent advancements in imaging, radiological, immunological, and molecular diagnostic methods, it is now possible to diagnose and treat ocular tuberculosis with greater accuracy, resulting in better treatment outcomes.
{"title":"Advances in the diagnosis of ocular tuberculosis","authors":"S. Handa, Hind Amin, Atul Arora, R. Agrawal, Vishali Gupta","doi":"10.1080/17469899.2023.2255746","DOIUrl":"https://doi.org/10.1080/17469899.2023.2255746","url":null,"abstract":"ABSTRACT Introduction Ocular tuberculosis (OTB) is a significant cause of visual morbidity and can have varied clinical manifestations. Recent advances in imaging and molecular diagnostic methods have greatly improved our understanding of the disease process. We conducted a search of published articles related to the diagnosis of ocular tuberculosis as of December 2021. Keywords were used to search the databases. Databases that were searched included PubMed and Scopus. Areas covered This review highlights the role of novel imaging modalities including ultra-widefield fundus photography, widefield fluorescein angiography, widefield indocyanine green angiography, swept-source optical coherence tomography, and optical coherence tomography angiography in the diagnosis of OTB. Radiological, immunological, and molecular diagnostic methods and their role in diagnosis of OTB have been discussed as well. Expert opinion With recent advancements in imaging, radiological, immunological, and molecular diagnostic methods, it is now possible to diagnose and treat ocular tuberculosis with greater accuracy, resulting in better treatment outcomes.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"18 1","pages":"261 - 269"},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41406189","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 : 2023-07-04DOI: 10.1080/17469899.2023.2248393
R. Hess, B. Thompson
We live in an ever-increasing digital world, digital applications and diagnostics are part and parcel of everyday clinical practice, particularly in Ophthalmology. All previous digital applications have been directed to improving our diagnostic capabilities but now, for the first time there is a digital pill. This is not a digitally activated/tracked pharmaceutical [1], this is a digital treatment per se, one designed to recover visual function in later life that had been lost in childhood. The neural substrate for this is residual neural plasticity present after the early critical period for visual development. There appear to be two pathways, a bottom-up one that is reliant on the appropriate dichoptic stimulation [2] while the other is a top-down one from higher brain areas that involves attention [3–5]. Treatment efficacy depends on activation of both pathways and there is an important role for AI in ensuring that attention is fully engaged for the duration of the bottom-up stimulation which is administered on a videogaming platform suitable for engaging young children.
{"title":"Can artificial intelligence be used to improve the quality of vision in patients with amblyopia? The first digital pill in medicine administered under AI","authors":"R. Hess, B. Thompson","doi":"10.1080/17469899.2023.2248393","DOIUrl":"https://doi.org/10.1080/17469899.2023.2248393","url":null,"abstract":"We live in an ever-increasing digital world, digital applications and diagnostics are part and parcel of everyday clinical practice, particularly in Ophthalmology. All previous digital applications have been directed to improving our diagnostic capabilities but now, for the first time there is a digital pill. This is not a digitally activated/tracked pharmaceutical [1], this is a digital treatment per se, one designed to recover visual function in later life that had been lost in childhood. The neural substrate for this is residual neural plasticity present after the early critical period for visual development. There appear to be two pathways, a bottom-up one that is reliant on the appropriate dichoptic stimulation [2] while the other is a top-down one from higher brain areas that involves attention [3–5]. Treatment efficacy depends on activation of both pathways and there is an important role for AI in ensuring that attention is fully engaged for the duration of the bottom-up stimulation which is administered on a videogaming platform suitable for engaging young children.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"18 1","pages":"223 - 225"},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49067560","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 : 2023-07-04DOI: 10.1080/17469899.2023.2258285
J. Aquavella, Esteban Santiago, J. Zavislan
The ‘Dry Eye’ definition has matured and evolved over time motivated by advances in technology, knowledge, and understanding of the disease. When TFOS DEWS first presented a definition in 2007, it was defined as a ‘multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface.’ In 2017, the same group added to the definition the concept of ‘loss of homeostasis of the tear film,’ ‘hyperosmolarity,’ ‘inflammation,’ and ‘neurosensory abnormalities.’ All these made a more complete definition of this complex and multifactorial condition [1]. In 2017, the Asia Dry Eye Society (ADES) describes and emphasizes the concept of ‘unstable tear film’ in their definition of dry eye creating a simpler classification oriented to creating a simpler diagnosis and management of these patients [2]. Nowadays, thanks to proliferative research and hard work of different societies to try to bring clarity to a disorder with a high level of complexity, the multifactorial characteristic of Dry Eye Disease is better understood, as is the concept of the lacrimal functional unit (LFU) and its role in the production and maintenance of a healthy ocular surface tear film [3,4].
{"title":"Advances in dry eye","authors":"J. Aquavella, Esteban Santiago, J. Zavislan","doi":"10.1080/17469899.2023.2258285","DOIUrl":"https://doi.org/10.1080/17469899.2023.2258285","url":null,"abstract":"The ‘Dry Eye’ definition has matured and evolved over time motivated by advances in technology, knowledge, and understanding of the disease. When TFOS DEWS first presented a definition in 2007, it was defined as a ‘multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface.’ In 2017, the same group added to the definition the concept of ‘loss of homeostasis of the tear film,’ ‘hyperosmolarity,’ ‘inflammation,’ and ‘neurosensory abnormalities.’ All these made a more complete definition of this complex and multifactorial condition [1]. In 2017, the Asia Dry Eye Society (ADES) describes and emphasizes the concept of ‘unstable tear film’ in their definition of dry eye creating a simpler classification oriented to creating a simpler diagnosis and management of these patients [2]. Nowadays, thanks to proliferative research and hard work of different societies to try to bring clarity to a disorder with a high level of complexity, the multifactorial characteristic of Dry Eye Disease is better understood, as is the concept of the lacrimal functional unit (LFU) and its role in the production and maintenance of a healthy ocular surface tear film [3,4].","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"31 1","pages":"231 - 234"},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139363092","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 : 2023-07-04DOI: 10.1080/17469899.2023.2258284
D. Shukla, Jay Kalliath, A. Dhawan
ABSTRACT Introduction Although we have been familiar with optic disc pits for a long time, the diagnosis and management of maculopathy remain unclear. Better imaging has improved the diagnosis of this subtle pathology. A recent update on the natural history of optic pit maculopathy marks a paradigm shift in the understanding and management of this condition. There is renewed scope for non-surgical management and less urgency for vitrectomy, which remains the definitive treatment. Areas covered This perspective highlights and critiques the updates on diagnostic imaging, natural history, indications and prognosis for surgery, non-surgical alternatives, and surgical adjuncts. We searched the Medline database using the keywords optic pit AND maculopathy, optic pit AND macular schisis, optic pit AND macular detachment; optic pit AND vitrectomy, optic pit AND laser photocoagulation, and included the salient articles. Expert commentary There has been no major change in the surgical options and outcomes for optic pit maculopathy in recent times, except a greater clarity on the role of vitrectomy without any adjuvants as the primary surgical procedure. The key updates are on better imaging for diagnosis and prognosis, and less urgency for surgery in view of the favorable natural history.
{"title":"Current advances in the management of optic disc pit maculopathy","authors":"D. Shukla, Jay Kalliath, A. Dhawan","doi":"10.1080/17469899.2023.2258284","DOIUrl":"https://doi.org/10.1080/17469899.2023.2258284","url":null,"abstract":"ABSTRACT Introduction Although we have been familiar with optic disc pits for a long time, the diagnosis and management of maculopathy remain unclear. Better imaging has improved the diagnosis of this subtle pathology. A recent update on the natural history of optic pit maculopathy marks a paradigm shift in the understanding and management of this condition. There is renewed scope for non-surgical management and less urgency for vitrectomy, which remains the definitive treatment. Areas covered This perspective highlights and critiques the updates on diagnostic imaging, natural history, indications and prognosis for surgery, non-surgical alternatives, and surgical adjuncts. We searched the Medline database using the keywords optic pit AND maculopathy, optic pit AND macular schisis, optic pit AND macular detachment; optic pit AND vitrectomy, optic pit AND laser photocoagulation, and included the salient articles. Expert commentary There has been no major change in the surgical options and outcomes for optic pit maculopathy in recent times, except a greater clarity on the role of vitrectomy without any adjuvants as the primary surgical procedure. The key updates are on better imaging for diagnosis and prognosis, and less urgency for surgery in view of the favorable natural history.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"31 1","pages":"249 - 259"},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139363243","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 : 2023-07-04DOI: 10.1080/17469899.2023.2258279
Giulia Coco, A. Taloni, V. Scorcia, G. Giannaccare
ABSTRACT Introduction Dry eye disease (DED) is a very common ocular condition with a considerable socioeconomic impact affecting patient’s visual function and quality of life. Currently, thanks to the better knowledge on DED pathophysiology, therapeutical approaches are focused on the primary core mechanisms of DED. Furthermore, new drugs and compounds are being explored in the light of recent findings concerning unique disease-related pathways. The purpose of this review is to stress DED pathogenesis, addressing its vicious cycle, and highlighting the cutting-edge drug therapy approaches under development. Areas covered A literature search on the PubMed and Scopus databases was carried out. The database search strategy was formulated around the term ‘dry eye disease’ and other terms regarding its pathophysiology and therapeutic strategy. Additional search was conducted on ClinicalTrials.gov for unpublished results and ongoing clinical trials. Expert opinion The primary approaches used for DED include lifestyle, environmental changes, tears supplementation, and control of the eyelids and ocular surface inflammation. In selected cases, medical therapy could benefit by technological device-based management. Due to the complexity of DED and the continuous growth of disease prevalence and patients’ unmet needs, new therapeutic approaches focused on its pathogenesis are currently under investigation, while others are pending approval.
{"title":"The vicious cycle of dry eye disease: a look into promising novel drug therapies","authors":"Giulia Coco, A. Taloni, V. Scorcia, G. Giannaccare","doi":"10.1080/17469899.2023.2258279","DOIUrl":"https://doi.org/10.1080/17469899.2023.2258279","url":null,"abstract":"ABSTRACT Introduction Dry eye disease (DED) is a very common ocular condition with a considerable socioeconomic impact affecting patient’s visual function and quality of life. Currently, thanks to the better knowledge on DED pathophysiology, therapeutical approaches are focused on the primary core mechanisms of DED. Furthermore, new drugs and compounds are being explored in the light of recent findings concerning unique disease-related pathways. The purpose of this review is to stress DED pathogenesis, addressing its vicious cycle, and highlighting the cutting-edge drug therapy approaches under development. Areas covered A literature search on the PubMed and Scopus databases was carried out. The database search strategy was formulated around the term ‘dry eye disease’ and other terms regarding its pathophysiology and therapeutic strategy. Additional search was conducted on ClinicalTrials.gov for unpublished results and ongoing clinical trials. Expert opinion The primary approaches used for DED include lifestyle, environmental changes, tears supplementation, and control of the eyelids and ocular surface inflammation. In selected cases, medical therapy could benefit by technological device-based management. Due to the complexity of DED and the continuous growth of disease prevalence and patients’ unmet needs, new therapeutic approaches focused on its pathogenesis are currently under investigation, while others are pending approval.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"51 1","pages":"235 - 247"},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139363080","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 : 2023-07-04DOI: 10.1080/17469899.2023.2258283
S. A. Schellini
The congenital absence or the acquired loss of an eye or its content causes a functional deficit and facial deformity that is also associated with poor psychological outcomes. The main goal of the treatment is to restore the appearance, and for that, it is mandatory to replace the volume of the lost eye, usually by a combination of orbital implants (OI) and external ocular prostheses (EOP) Figure 1. Symmetry, satisfactory eyelid and eyelid closure, adequate orbital volume, and motility of the EOP are the main issues to be addressed [1]. This is a complex topic that requires an understanding of the anatomy of the eyelids, fornices, and orbit as well as a thorough understanding of the associated surgical techniques and disposable OIs. Optimal collaboration between ophthalmologists and ocularists using customized EOP, patient/parental motivation, and long-term follow-up adherence are the keys to achieving success.
{"title":"Perspectives on the clinical feasibility of techniques used in anophthalmic socket reconstruction","authors":"S. A. Schellini","doi":"10.1080/17469899.2023.2258283","DOIUrl":"https://doi.org/10.1080/17469899.2023.2258283","url":null,"abstract":"The congenital absence or the acquired loss of an eye or its content causes a functional deficit and facial deformity that is also associated with poor psychological outcomes. The main goal of the treatment is to restore the appearance, and for that, it is mandatory to replace the volume of the lost eye, usually by a combination of orbital implants (OI) and external ocular prostheses (EOP) Figure 1. Symmetry, satisfactory eyelid and eyelid closure, adequate orbital volume, and motility of the EOP are the main issues to be addressed [1]. This is a complex topic that requires an understanding of the anatomy of the eyelids, fornices, and orbit as well as a thorough understanding of the associated surgical techniques and disposable OIs. Optimal collaboration between ophthalmologists and ocularists using customized EOP, patient/parental motivation, and long-term follow-up adherence are the keys to achieving success.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"8 1","pages":"227 - 230"},"PeriodicalIF":0.7,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139362929","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 : 2023-06-18DOI: 10.1080/17469899.2023.2224565
I. Mirzayev, A. Gündüz, Ö. Gündüz
{"title":"Anterior segment optical coherence tomography in iris and ciliary body tumors: a systematic review","authors":"I. Mirzayev, A. Gündüz, Ö. Gündüz","doi":"10.1080/17469899.2023.2224565","DOIUrl":"https://doi.org/10.1080/17469899.2023.2224565","url":null,"abstract":"","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41816819","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 : 2023-05-04DOI: 10.1080/17469899.2023.2245143
B. Darlow
ABSTRACT Introduction Primary prevention of retinopathy of prematurity (ROP) is sparingly covered in recent literature but is both possible and highly cost-effective Areas covered The variation in incidence of ROP between neonatal units (NICUs) in large neonatal networks provides clues as to primary prevention of ROP. Differences in beneficial evidence-based care practices include use of antenatal corticosteroids, labor ward care, use of caffeine, facilitating human milk feeding, improved nutrition, and prevention of sepsis. Recent large trials show oxygen saturation targets should be higher than 85–89% to improve survival of very preterm infants, whilst avoiding fluctuations in oxygenation. Multifaceted quality improvement programs in neonatal networks that focus on using known evidence-based practices and addressing attitudes, knowledge, and clinical biases have resulted in steady improvement in ROP rates over several years. Consistently, better performing NICUs have a positive ‘culture’ that fosters team work, camaraderie, and learning opportunities. In poorly resourced low and middle-income countries (LMICs), increasing awareness of ROP and undertaking data collection are important first steps, and there are several low-cost measures that can be taken to reduce ROP rates. Literature searches were undertaken through PubMed. Expert opinion ROP has a multifactorial etiology, and a multifaceted approach is required for prevention.
{"title":"Primary prevention of ROP: more can be done in all settings","authors":"B. Darlow","doi":"10.1080/17469899.2023.2245143","DOIUrl":"https://doi.org/10.1080/17469899.2023.2245143","url":null,"abstract":"ABSTRACT Introduction Primary prevention of retinopathy of prematurity (ROP) is sparingly covered in recent literature but is both possible and highly cost-effective Areas covered The variation in incidence of ROP between neonatal units (NICUs) in large neonatal networks provides clues as to primary prevention of ROP. Differences in beneficial evidence-based care practices include use of antenatal corticosteroids, labor ward care, use of caffeine, facilitating human milk feeding, improved nutrition, and prevention of sepsis. Recent large trials show oxygen saturation targets should be higher than 85–89% to improve survival of very preterm infants, whilst avoiding fluctuations in oxygenation. Multifaceted quality improvement programs in neonatal networks that focus on using known evidence-based practices and addressing attitudes, knowledge, and clinical biases have resulted in steady improvement in ROP rates over several years. Consistently, better performing NICUs have a positive ‘culture’ that fosters team work, camaraderie, and learning opportunities. In poorly resourced low and middle-income countries (LMICs), increasing awareness of ROP and undertaking data collection are important first steps, and there are several low-cost measures that can be taken to reduce ROP rates. Literature searches were undertaken through PubMed. Expert opinion ROP has a multifactorial etiology, and a multifaceted approach is required for prevention.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"18 1","pages":"177 - 191"},"PeriodicalIF":0.7,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44521048","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 : 2023-05-04DOI: 10.1080/17469899.2023.2245147
I. Halkiadakis, Dimitrios S. Ladas, K. Chatzistefanou, N. Markomichelakis
Anterior uveitis (AU) is the commonest type of uveitis [1,2]. Most cases (48–70%) are considered idiopathic. HLA-B27-associated spondyloarthritis is the most common systemic disease associated with adult AU. It was reported in 18–32% of patients with AU in Western countries and in 6–13% of patients with AU in Asia [3]. AU in children is also frequently associated with juvenile idiopathic arthritis. Several other causes of AU have been described in the literature including herpes family virus, syphilis, tuberculosis, sarcoidosis, tubulointerstitial nephritis and uveitis syndrome, and Adamantiades–Bechet’s disease (ABD) [4]. In terms of disease duration, AU has been divided into acute, recurrent, and chronic. A chronic course is defined as episode duration over 3 months or relapses within less than 3 months of treatment cessation [5]. Chronic AU has been linked to an increased risk for loss of vision from serious complications such as glaucoma, cataract, band keratopathy, cystoid macular edema, and phthisis bulbi [4]. Prompt identification of possible infectious causes or systemic associations may prevent complications and loss of vision and can positively affect the overall visual prognosis and the patient’s quality of life [6]. For example, in patients with juvenile idiopathic arthritis (JIA)-associated chronic AU, the use of immunosuppression reduces the risk of vision loss by ~ 40% [7] and an early identification of herpetic AU may significantly reduce the risk of glaucoma and cataract formation [8].
{"title":"Cytomegalovirus anterior uveitis: how does it compare to the characteristics of other anterior uveitides to provide unique management opportunities","authors":"I. Halkiadakis, Dimitrios S. Ladas, K. Chatzistefanou, N. Markomichelakis","doi":"10.1080/17469899.2023.2245147","DOIUrl":"https://doi.org/10.1080/17469899.2023.2245147","url":null,"abstract":"Anterior uveitis (AU) is the commonest type of uveitis [1,2]. Most cases (48–70%) are considered idiopathic. HLA-B27-associated spondyloarthritis is the most common systemic disease associated with adult AU. It was reported in 18–32% of patients with AU in Western countries and in 6–13% of patients with AU in Asia [3]. AU in children is also frequently associated with juvenile idiopathic arthritis. Several other causes of AU have been described in the literature including herpes family virus, syphilis, tuberculosis, sarcoidosis, tubulointerstitial nephritis and uveitis syndrome, and Adamantiades–Bechet’s disease (ABD) [4]. In terms of disease duration, AU has been divided into acute, recurrent, and chronic. A chronic course is defined as episode duration over 3 months or relapses within less than 3 months of treatment cessation [5]. Chronic AU has been linked to an increased risk for loss of vision from serious complications such as glaucoma, cataract, band keratopathy, cystoid macular edema, and phthisis bulbi [4]. Prompt identification of possible infectious causes or systemic associations may prevent complications and loss of vision and can positively affect the overall visual prognosis and the patient’s quality of life [6]. For example, in patients with juvenile idiopathic arthritis (JIA)-associated chronic AU, the use of immunosuppression reduces the risk of vision loss by ~ 40% [7] and an early identification of herpetic AU may significantly reduce the risk of glaucoma and cataract formation [8].","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"18 1","pages":"155 - 157"},"PeriodicalIF":0.7,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44476930","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 : 2023-05-04DOI: 10.1080/17469899.2023.2245145
J. Pearce, B. Rai
ABSTRACT Introduction The day-1 topical antibiotic treatment for bacterial keratitis (BK) can have a significant impact on treatment outcomes. Symptoms associated with this condition (pain, photophobia, blepharospasm and increased lacrimation) may compromise the effectiveness of topical antibiotic treatment by reducing the antibiotic contact time with the cornea. Topical ocular local anaesthetics (TOLAs) have the potential to alleviate these symptoms and thus potentiate the effect of the antibiotic drops instilled. Areas covered The literature on possible ocular side-effects of TOLAs was searched using Google and PubMed databases (Filters: Humans, English, abstract available), with no filters applied for date of publication. Relevant papers were reviewed, and possible barriers to their use on day-1 in the treatment of BK were identified, examined, and either found to be not applicable to short term use or strategies were identified to resolve any barriers. Published evidence to support the possible potentiation of antibiotic effect via the use of TOLAs was also reviewed. Expert opinion Perceived barriers to the short-term use of TOLAs in BK are not supported by the literature, and there is evidence to suggest that higher corneal antibiotic concentrations may be achieved by using TOLAs in conjunction with topical antibiotic drops in BK on day-1.
{"title":"Topical ocular local anaesthetics as an adjunctive measure in the day-1 treatment of bacterial keratitis","authors":"J. Pearce, B. Rai","doi":"10.1080/17469899.2023.2245145","DOIUrl":"https://doi.org/10.1080/17469899.2023.2245145","url":null,"abstract":"ABSTRACT Introduction The day-1 topical antibiotic treatment for bacterial keratitis (BK) can have a significant impact on treatment outcomes. Symptoms associated with this condition (pain, photophobia, blepharospasm and increased lacrimation) may compromise the effectiveness of topical antibiotic treatment by reducing the antibiotic contact time with the cornea. Topical ocular local anaesthetics (TOLAs) have the potential to alleviate these symptoms and thus potentiate the effect of the antibiotic drops instilled. Areas covered The literature on possible ocular side-effects of TOLAs was searched using Google and PubMed databases (Filters: Humans, English, abstract available), with no filters applied for date of publication. Relevant papers were reviewed, and possible barriers to their use on day-1 in the treatment of BK were identified, examined, and either found to be not applicable to short term use or strategies were identified to resolve any barriers. Published evidence to support the possible potentiation of antibiotic effect via the use of TOLAs was also reviewed. Expert opinion Perceived barriers to the short-term use of TOLAs in BK are not supported by the literature, and there is evidence to suggest that higher corneal antibiotic concentrations may be achieved by using TOLAs in conjunction with topical antibiotic drops in BK on day-1.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"18 1","pages":"159 - 166"},"PeriodicalIF":0.7,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41349439","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}
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