Pub Date : 2022-09-03DOI: 10.1080/17469899.2022.2131541
Semih Ceylan, O. Özalp, E. Atalay
Dementia is defined as the irreversible deterioration of acquired cognitive abilities (executive functions, memory, language, visuospatial, and motor) because of progressive neurodegeneration. According to a report by the World Health Organization (WHO) in 2018, dementia ranks as the 7 most common worldwide cause of death. In 2018, the globally estimated number of people afflicted by dementia was 50 million, a figure which is expected to triple by the year 2050 [1]. The worldwide rapidly aging population and the resultant unprecedented rise in the incidence of dementia are anticipated to cause a greater burden in health expenditures both in underdeveloped and developed countries alike. Optical coherence tomography angiography (OCT-A) is a noninvasive and facile method for visualizing retinal and choroidal microcirculation obviating the need for administering a systemic contrast agent. Compared to other brain imaging modalities, such as positron emission tomography imaging, it is more cost-effective and rapidly allows layer-bylayer assessment of retinochoroidal microcirculation. In a routine retina clinic, OCT-A is mainly employed for the diagnosis and monitoring of age-related macular degeneration and diabetic retinopathy. It has also become a popular research tool for assessing peripapillary and macular microcirculation in glaucoma and other optic neuropathies with the hope of finding various vascular cues that may enable earlier disease diagnosis and/or the detection of its progression [2]. In addition to its indispensable role in a busy ophthalmology clinic, studies have shown that OCT-A may potentially be a highly useful ancillary tool in various other non-ophthalmic diseases that directly or indirectly impact retinal and/or choriocapillaris microcirculation, such as multiple sclerosis, Parkinson’s, and Alzheimer’s diseases [3].
{"title":"A peek at the window from the eye into the brain: potential use of OCT angiography in dementia","authors":"Semih Ceylan, O. Özalp, E. Atalay","doi":"10.1080/17469899.2022.2131541","DOIUrl":"https://doi.org/10.1080/17469899.2022.2131541","url":null,"abstract":"Dementia is defined as the irreversible deterioration of acquired cognitive abilities (executive functions, memory, language, visuospatial, and motor) because of progressive neurodegeneration. According to a report by the World Health Organization (WHO) in 2018, dementia ranks as the 7 most common worldwide cause of death. In 2018, the globally estimated number of people afflicted by dementia was 50 million, a figure which is expected to triple by the year 2050 [1]. The worldwide rapidly aging population and the resultant unprecedented rise in the incidence of dementia are anticipated to cause a greater burden in health expenditures both in underdeveloped and developed countries alike. Optical coherence tomography angiography (OCT-A) is a noninvasive and facile method for visualizing retinal and choroidal microcirculation obviating the need for administering a systemic contrast agent. Compared to other brain imaging modalities, such as positron emission tomography imaging, it is more cost-effective and rapidly allows layer-bylayer assessment of retinochoroidal microcirculation. In a routine retina clinic, OCT-A is mainly employed for the diagnosis and monitoring of age-related macular degeneration and diabetic retinopathy. It has also become a popular research tool for assessing peripapillary and macular microcirculation in glaucoma and other optic neuropathies with the hope of finding various vascular cues that may enable earlier disease diagnosis and/or the detection of its progression [2]. In addition to its indispensable role in a busy ophthalmology clinic, studies have shown that OCT-A may potentially be a highly useful ancillary tool in various other non-ophthalmic diseases that directly or indirectly impact retinal and/or choriocapillaris microcirculation, such as multiple sclerosis, Parkinson’s, and Alzheimer’s diseases [3].","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"295 - 297"},"PeriodicalIF":0.7,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43549570","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 : 2022-09-03DOI: 10.1080/17469899.2022.2138345
E. Abu, Odeefour A Ofori, S. Boadi-Kusi, S. Ocansey, Richard K Yankah, Selassie K Dzasimatu, A. Y. Awuku
ABSTRACT Background To investigate the impact of dry eye syndrome (DES) on dry eye-related quality of life (QoL) in patients with type 2 diabetes. Research design and methods Evaluation of DES included assessment of meibomian gland function, tear breakup time (TBUT), Schirmer test, fluorescein ocular surface staining, and Ocular Surface Disease Index (OSDI) scores. DES diagnosis was based on OSDI score ≥13, TBUT < 10s, and fluorescein staining. Results After adjusting for age, duration of diabetes, drug usage, and comorbidities, severity of DES symptomatology and signs resulted in poorer QoL of patients when comparing cases and controls. TBUT, meibum quality, and ocular surface staining were the objective clinical tests that significantly correlated with QoL. Poor QoL was also associated with the presence of eyelash and eyelid anomalies (eyelash: aOR = 2.58, CI = 1.49–4.47, p = 0.001; eyelids: aOR = 1.66, CI = 1.01–2.71, p = 0.04). Patients who had been previously diagnosed and treated for DES registered improved QoL measures. Conclusions Symptoms or clinical signs of DES resulted in poorer QoL in a clinical sample of type 2 diabetes patients, stressing the need for clinicians to evaluate such signs and symptoms in order to improve QoL.
{"title":"Dry eye-related quality of life among type 2 diabetes patients: a hospital-based cross-sectional study","authors":"E. Abu, Odeefour A Ofori, S. Boadi-Kusi, S. Ocansey, Richard K Yankah, Selassie K Dzasimatu, A. Y. Awuku","doi":"10.1080/17469899.2022.2138345","DOIUrl":"https://doi.org/10.1080/17469899.2022.2138345","url":null,"abstract":"ABSTRACT Background To investigate the impact of dry eye syndrome (DES) on dry eye-related quality of life (QoL) in patients with type 2 diabetes. Research design and methods Evaluation of DES included assessment of meibomian gland function, tear breakup time (TBUT), Schirmer test, fluorescein ocular surface staining, and Ocular Surface Disease Index (OSDI) scores. DES diagnosis was based on OSDI score ≥13, TBUT < 10s, and fluorescein staining. Results After adjusting for age, duration of diabetes, drug usage, and comorbidities, severity of DES symptomatology and signs resulted in poorer QoL of patients when comparing cases and controls. TBUT, meibum quality, and ocular surface staining were the objective clinical tests that significantly correlated with QoL. Poor QoL was also associated with the presence of eyelash and eyelid anomalies (eyelash: aOR = 2.58, CI = 1.49–4.47, p = 0.001; eyelids: aOR = 1.66, CI = 1.01–2.71, p = 0.04). Patients who had been previously diagnosed and treated for DES registered improved QoL measures. Conclusions Symptoms or clinical signs of DES resulted in poorer QoL in a clinical sample of type 2 diabetes patients, stressing the need for clinicians to evaluate such signs and symptoms in order to improve QoL.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"353 - 359"},"PeriodicalIF":0.7,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46823253","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 : 2022-09-03DOI: 10.1080/17469899.2022.2137493
A. Kawali, Aayesha Khanum, P. Mahendradas, S. Sanjay, R. Shetty
ABSTRACT Introduction Varicella zoster virus (VZV) uveitis presenting as acute retinal necrosis with vasculitis is well known, but VZV-vasculitis without retinitis is rarely reported. Identification of such presentation can be challenging, especially when other signs of ocular VZV are absent. This is particularly important before considering immunomodulatory therapy for retinal vasculitis without systemic manifestations. Areas covered An online English language literature search for ‘VZV retinal vasculitis presenting without retinitis’ was made and case reports and case series published from 1995 to 2020 were reviewed. The search revealed 26 cases from 21 reports in 25 years. The clinical manifestation, morphology of vasculitis, visual and treatment outcomes were studied. Expert opinion Recent or old history of Herpes Zoster Ophthalmicus or chickenpox especially in young individuals should be elicited in isolated retinal vasculitis. Diagnostic relevance of PCR and serological tests should be investigated further in larger studies. Occlusive nature of vasculitis, including arteriolitis, is common in VZV infection. In chronic cases, end point of antiviral therapy remains unknown. Patients should be warned of grave visual prognosis despite adequate treatment. The importance of adjuvant anti-thrombotic therapy along with anti-viral and immunomodulatory therapy needs to be explored further.
{"title":"Varicella zoster retinal vasculitis without retinitis: a literature review","authors":"A. Kawali, Aayesha Khanum, P. Mahendradas, S. Sanjay, R. Shetty","doi":"10.1080/17469899.2022.2137493","DOIUrl":"https://doi.org/10.1080/17469899.2022.2137493","url":null,"abstract":"ABSTRACT Introduction Varicella zoster virus (VZV) uveitis presenting as acute retinal necrosis with vasculitis is well known, but VZV-vasculitis without retinitis is rarely reported. Identification of such presentation can be challenging, especially when other signs of ocular VZV are absent. This is particularly important before considering immunomodulatory therapy for retinal vasculitis without systemic manifestations. Areas covered An online English language literature search for ‘VZV retinal vasculitis presenting without retinitis’ was made and case reports and case series published from 1995 to 2020 were reviewed. The search revealed 26 cases from 21 reports in 25 years. The clinical manifestation, morphology of vasculitis, visual and treatment outcomes were studied. Expert opinion Recent or old history of Herpes Zoster Ophthalmicus or chickenpox especially in young individuals should be elicited in isolated retinal vasculitis. Diagnostic relevance of PCR and serological tests should be investigated further in larger studies. Occlusive nature of vasculitis, including arteriolitis, is common in VZV infection. In chronic cases, end point of antiviral therapy remains unknown. Patients should be warned of grave visual prognosis despite adequate treatment. The importance of adjuvant anti-thrombotic therapy along with anti-viral and immunomodulatory therapy needs to be explored further.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"333 - 341"},"PeriodicalIF":0.7,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46320556","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 : 2022-09-03DOI: 10.1080/17469899.2022.2139678
M. Kole, J. C. Martinez‐Gutierrez, Francisio Sanchez, Rosa A. Tang, P. Chen
ABSTRACT Introduction Idiopathic intracranial hypertension (IIH) is a disease of excess cerebrospinal fluid (CSF) leading to rising intracranial pressure. Patients most commonly present with headache, tinnitus, papilledema, and vision loss. It most commonly affects young overweight females, a growing population. Traditional management has consisted of weight loss, medical management, surgical CSF diversion, and optic nerve sheath fenestration. In recent years, cerebral venous sinus stenosis has been described as an almost ubiquitously present potentiator of this disease. Venous sinus stenting to normalize cerebral venous outflow has emerged as a highly effective treatment. Areas covered In this review, the authors review the epidemiology and pathophysiology of IIH, as well as its common management strategies. The authors focus on the emergence of venous sinus stenting as a safe, effective, and minimally invasive strategy for managing IIH. Expert opinion IIH caused by venous sinus stenosis can be treated effectively and safely with endovascular stenting of the sinus. Given its low morbidity and failure rate relative to other traditional management strategies, evaluation for venous sinus stenosis should be pursued in this patient population, and referral to a neuro-endovascular specialist made if indicated.
{"title":"Dural venous sinus stenting in patients with idiopathic intracranial hypertension: report of outcomes from a single-center prospective database and literature review","authors":"M. Kole, J. C. Martinez‐Gutierrez, Francisio Sanchez, Rosa A. Tang, P. Chen","doi":"10.1080/17469899.2022.2139678","DOIUrl":"https://doi.org/10.1080/17469899.2022.2139678","url":null,"abstract":"ABSTRACT Introduction Idiopathic intracranial hypertension (IIH) is a disease of excess cerebrospinal fluid (CSF) leading to rising intracranial pressure. Patients most commonly present with headache, tinnitus, papilledema, and vision loss. It most commonly affects young overweight females, a growing population. Traditional management has consisted of weight loss, medical management, surgical CSF diversion, and optic nerve sheath fenestration. In recent years, cerebral venous sinus stenosis has been described as an almost ubiquitously present potentiator of this disease. Venous sinus stenting to normalize cerebral venous outflow has emerged as a highly effective treatment. Areas covered In this review, the authors review the epidemiology and pathophysiology of IIH, as well as its common management strategies. The authors focus on the emergence of venous sinus stenting as a safe, effective, and minimally invasive strategy for managing IIH. Expert opinion IIH caused by venous sinus stenosis can be treated effectively and safely with endovascular stenting of the sinus. Given its low morbidity and failure rate relative to other traditional management strategies, evaluation for venous sinus stenosis should be pursued in this patient population, and referral to a neuro-endovascular specialist made if indicated.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"321 - 331"},"PeriodicalIF":0.7,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42046283","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 : 2022-09-03DOI: 10.1080/17469899.2022.2131539
Christopher M. Maatouk, Resya Sastry, Rishi P. Singh
ABSTRACT Introduction Anti-VEGF agents have been demonstrated to be more effective than sham or laser in treating center-involving diabetic macular edema (DME) in short-term pivotal trials. The literature regarding long-term outcomes (5 years or more) of anti-VEGF treatments in DME is limited. Areas covered A literature search was conducted using the PubMed and Cochrane Library databases. Key words included ‘diabetic macular edema,’ ‘diabetic retinopathy,’ ‘vascular endothelial growth factor,’ ‘anti-VEGF,’ ‘long*,’ and ‘five-year.’ 21 articles were included in the final review that examined the 5-year visual and anatomic outcomes of anti-VEGF treatments in DME. Combined analysis of the mean 5-year change in visual acuity and central retinal thickness was conducted. Expert opinion Anti-VEGF agents provide significant vision and anatomic improvements to patients with DME through at least 5 years of treatment. Given their minimal adverse effect profile, superior impact on visual and anatomic outcomes, and likely cost benefit, anti-VEGF agents should be initiated as early as possible in individuals with clinically significant DME causing vision loss. Further work is required to identify early indicators of poor treatment response and to develop longer-acting anti-VEGF treatments.
{"title":"Long term outcomes following anti-VEGF therapy for diabetic macular edema","authors":"Christopher M. Maatouk, Resya Sastry, Rishi P. Singh","doi":"10.1080/17469899.2022.2131539","DOIUrl":"https://doi.org/10.1080/17469899.2022.2131539","url":null,"abstract":"ABSTRACT Introduction Anti-VEGF agents have been demonstrated to be more effective than sham or laser in treating center-involving diabetic macular edema (DME) in short-term pivotal trials. The literature regarding long-term outcomes (5 years or more) of anti-VEGF treatments in DME is limited. Areas covered A literature search was conducted using the PubMed and Cochrane Library databases. Key words included ‘diabetic macular edema,’ ‘diabetic retinopathy,’ ‘vascular endothelial growth factor,’ ‘anti-VEGF,’ ‘long*,’ and ‘five-year.’ 21 articles were included in the final review that examined the 5-year visual and anatomic outcomes of anti-VEGF treatments in DME. Combined analysis of the mean 5-year change in visual acuity and central retinal thickness was conducted. Expert opinion Anti-VEGF agents provide significant vision and anatomic improvements to patients with DME through at least 5 years of treatment. Given their minimal adverse effect profile, superior impact on visual and anatomic outcomes, and likely cost benefit, anti-VEGF agents should be initiated as early as possible in individuals with clinically significant DME causing vision loss. Further work is required to identify early indicators of poor treatment response and to develop longer-acting anti-VEGF treatments.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"307 - 319"},"PeriodicalIF":0.7,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48561191","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 : 2022-09-03DOI: 10.1080/17469899.2022.2138346
Anita Syla Lokaj, Gazmend Kaçaniku, K. Spahiu, Faruk Semiz
ABSTRACT Background This study aimed to analyze the central corneal thickness (CCT) in diabetic patients with and without diabetic retinopathy (DR) by investigating the impacts of other CCT factors such as hemoglobin A1c (HbA1c) levels, diabetes mellitus (DM) duration, and the DR stages. The study also compared the results of two measuring devices – anterior segment-optical coherence tomography (AS-OCT) and ultrasound pachymetry (UP). However, the existing research possesses bias in revealing the precise measurement of CCT. Research design and methods The study enrolled 300 participants who were segregated into three equal groups: group A with DR, group B without DR, and the control group. The study tested the following formulated hypothesis, like the correlation between the age, duration, and HbA1c level of diabetic patients with DR and without DR. The effectiveness of the AS-OCT and UP was assessed through statistical analysis. Results The experiment revealed a considerable statistical difference in the formulated hypothesis and observed that AS-OCT had higher efficacy than UP in estimating CCT in all the groups. Conclusions The study recommends the prompt utilization of devices such as AS-OCT to precisely predict CCT. This could greatly benefit DM patients with retinopathy conditions for better decision-making and reliable measures during glaucoma surgery.
{"title":"Prediction of a reliable method for the estimation of central corneal thickness in diabetic patients with and without diabetic retinopathy","authors":"Anita Syla Lokaj, Gazmend Kaçaniku, K. Spahiu, Faruk Semiz","doi":"10.1080/17469899.2022.2138346","DOIUrl":"https://doi.org/10.1080/17469899.2022.2138346","url":null,"abstract":"ABSTRACT Background This study aimed to analyze the central corneal thickness (CCT) in diabetic patients with and without diabetic retinopathy (DR) by investigating the impacts of other CCT factors such as hemoglobin A1c (HbA1c) levels, diabetes mellitus (DM) duration, and the DR stages. The study also compared the results of two measuring devices – anterior segment-optical coherence tomography (AS-OCT) and ultrasound pachymetry (UP). However, the existing research possesses bias in revealing the precise measurement of CCT. Research design and methods The study enrolled 300 participants who were segregated into three equal groups: group A with DR, group B without DR, and the control group. The study tested the following formulated hypothesis, like the correlation between the age, duration, and HbA1c level of diabetic patients with DR and without DR. The effectiveness of the AS-OCT and UP was assessed through statistical analysis. Results The experiment revealed a considerable statistical difference in the formulated hypothesis and observed that AS-OCT had higher efficacy than UP in estimating CCT in all the groups. Conclusions The study recommends the prompt utilization of devices such as AS-OCT to precisely predict CCT. This could greatly benefit DM patients with retinopathy conditions for better decision-making and reliable measures during glaucoma surgery.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"361 - 369"},"PeriodicalIF":0.7,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43286773","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 : 2022-09-03DOI: 10.1080/17469899.2022.2126832
F. Jinadu, Iskilu Adekunle Jolaoso, Modupe balagun, T. Ottun, Ufuoma Oluwaseyi Olumodeji, A. Olumodeji
ABSTRACT Background We compared ultrasonic ocular axial length and vitreous chamber depth, and physical anthropometry in normal and myopic African adults due to sparse related data in this setting. Research design and methods This was a hospital-based, case-control study in which 175 myopes and 175 emmetropes, recruited by convenience sampling, at General Hospital Epe, Lagos, had their anthropometry and refractive status determined; and ocular axial length and vitreous chamber depth measured with A- and B-mode ocular ultrasonography. Data was analyzed using appropriate inferential statistics and level of significance set at 0.05. Results Mean ocular axial length in normal, mild, moderate and severe myopia was 22.45mm, 23.54mm, 23.79mm, and 25.56mm while mean vitreous chamber depth in normal, mild, moderate, and severe myopia was 15.45mm, 16.63mm, 16.84mm, and 18.68mm, respectively. Males had significantly longer axial length and vitreous chamber depth than females. Correlation between weight, height and BMI and refractive status among myopes was insignificant. There was consistency between A- and B-mode ultrasonography ocular axial length and vitreous chamber measurements with a Cronbach’s Alpha of 0.888 and 0.842, respectively (p<0.001). Conclusion Ocular axial length and vitreous chamber depth increased with the severity of myopia with no correlation of anthropometry with refractive status among African myopes.
{"title":"Ultrasonic ocular dimensions and anthropometry in normal and myopic eyes: a case-control study","authors":"F. Jinadu, Iskilu Adekunle Jolaoso, Modupe balagun, T. Ottun, Ufuoma Oluwaseyi Olumodeji, A. Olumodeji","doi":"10.1080/17469899.2022.2126832","DOIUrl":"https://doi.org/10.1080/17469899.2022.2126832","url":null,"abstract":"ABSTRACT Background We compared ultrasonic ocular axial length and vitreous chamber depth, and physical anthropometry in normal and myopic African adults due to sparse related data in this setting. Research design and methods This was a hospital-based, case-control study in which 175 myopes and 175 emmetropes, recruited by convenience sampling, at General Hospital Epe, Lagos, had their anthropometry and refractive status determined; and ocular axial length and vitreous chamber depth measured with A- and B-mode ocular ultrasonography. Data was analyzed using appropriate inferential statistics and level of significance set at 0.05. Results Mean ocular axial length in normal, mild, moderate and severe myopia was 22.45mm, 23.54mm, 23.79mm, and 25.56mm while mean vitreous chamber depth in normal, mild, moderate, and severe myopia was 15.45mm, 16.63mm, 16.84mm, and 18.68mm, respectively. Males had significantly longer axial length and vitreous chamber depth than females. Correlation between weight, height and BMI and refractive status among myopes was insignificant. There was consistency between A- and B-mode ultrasonography ocular axial length and vitreous chamber measurements with a Cronbach’s Alpha of 0.888 and 0.842, respectively (p<0.001). Conclusion Ocular axial length and vitreous chamber depth increased with the severity of myopia with no correlation of anthropometry with refractive status among African myopes.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"343 - 351"},"PeriodicalIF":0.7,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46392369","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 : 2022-07-04DOI: 10.1080/17469899.2022.2108405
M. Packer
Independence from eyeglasses and contact lenses has significant value: ‘The global refractive surgery devices market size was valued at USD 168.2 million in 2020 and is expected to expand at a compound annual growth (CAGR) of 7.7% from 2021 to 2028’ [1]. In addition, ‘Global demand for refractive surgical procedures (laser refractive surgery, presbyopiacorrecting surgery, RLE [Refractive Lens Exchange], and phakic IOL implantation) is expected to grow at a compound annual rate of 9.6% from 2020 to 2025, with annual surgical volume increasing from 3.6 million to 5.8 million procedures’ [2]. Considering the United States alone, it has been reported that ‘The vision correction market generated professional service fees of over $5 billion in 2016 and by 2019 it increased to $6.3 billion mainly provided by independent eye care providers’ [3]. These numbers reflect the high levels of satisfaction achieved with refractive procedures. For example, ‘98.7% of all patients were satisfied or very satisfied after their LASIK surgery’ [4], and ‘99.4% of 1,542 patients surveyed’ stated that they would elect to have the EVO implantable collamer lens (ICL) again [5]. As options for refractive correction have increased, the range of potential surgical candidates has broadened. Today, procedures are available for virtually any type of refractive error, as well as presbyopia. Establishing candidacy for refractive surgery involves assessment of the patient’s motivation and medical condition. The ideal candidate is highly motivated and has a normal visual system apart from refractive error and/or presbyopia. Every incremental decrease in motivation or increase in pertinent findings alters the risk benefit ratio, until the balance swings away from intervention. However, risks related to physical findings may be mitigated by the choice of procedure. Common significant findings that increase surgical risk or impact the choice of procedure include ocular surface disease [6], signs that increase suspicion of corneal ectasia [7], corneal endothelial insufficiency [8], shallow anterior chamber depth or narrow anterior chamber angle [9], incipient or frank cataract [10], signs of ocular inflammation or uveitis [11], glaucoma [12], macular disorders [13], and predisposing lesions that increase the risk of retinal detachment [14]. Age and refractive error primarily determine the choice of procedure, while physical findings play an important secondary role. In addition, patient expectations may influence the decision. For example, knowledge of LASIK is widespread due to its high-profile introduction in the late 1990s [15], extensive marketing by corporate laser vision centers [16] and subsequent controversies regarding untoward outcomes [17]. Because it is commonly equated with refractive surgery, patients may arrive at the doctor’s office expecting to be offered LASIK and unaware that other options exist. All else being equal, it is sometimes easier for a doctor to simply agree
{"title":"Refractive surgery current status: expanding options","authors":"M. Packer","doi":"10.1080/17469899.2022.2108405","DOIUrl":"https://doi.org/10.1080/17469899.2022.2108405","url":null,"abstract":"Independence from eyeglasses and contact lenses has significant value: ‘The global refractive surgery devices market size was valued at USD 168.2 million in 2020 and is expected to expand at a compound annual growth (CAGR) of 7.7% from 2021 to 2028’ [1]. In addition, ‘Global demand for refractive surgical procedures (laser refractive surgery, presbyopiacorrecting surgery, RLE [Refractive Lens Exchange], and phakic IOL implantation) is expected to grow at a compound annual rate of 9.6% from 2020 to 2025, with annual surgical volume increasing from 3.6 million to 5.8 million procedures’ [2]. Considering the United States alone, it has been reported that ‘The vision correction market generated professional service fees of over $5 billion in 2016 and by 2019 it increased to $6.3 billion mainly provided by independent eye care providers’ [3]. These numbers reflect the high levels of satisfaction achieved with refractive procedures. For example, ‘98.7% of all patients were satisfied or very satisfied after their LASIK surgery’ [4], and ‘99.4% of 1,542 patients surveyed’ stated that they would elect to have the EVO implantable collamer lens (ICL) again [5]. As options for refractive correction have increased, the range of potential surgical candidates has broadened. Today, procedures are available for virtually any type of refractive error, as well as presbyopia. Establishing candidacy for refractive surgery involves assessment of the patient’s motivation and medical condition. The ideal candidate is highly motivated and has a normal visual system apart from refractive error and/or presbyopia. Every incremental decrease in motivation or increase in pertinent findings alters the risk benefit ratio, until the balance swings away from intervention. However, risks related to physical findings may be mitigated by the choice of procedure. Common significant findings that increase surgical risk or impact the choice of procedure include ocular surface disease [6], signs that increase suspicion of corneal ectasia [7], corneal endothelial insufficiency [8], shallow anterior chamber depth or narrow anterior chamber angle [9], incipient or frank cataract [10], signs of ocular inflammation or uveitis [11], glaucoma [12], macular disorders [13], and predisposing lesions that increase the risk of retinal detachment [14]. Age and refractive error primarily determine the choice of procedure, while physical findings play an important secondary role. In addition, patient expectations may influence the decision. For example, knowledge of LASIK is widespread due to its high-profile introduction in the late 1990s [15], extensive marketing by corporate laser vision centers [16] and subsequent controversies regarding untoward outcomes [17]. Because it is commonly equated with refractive surgery, patients may arrive at the doctor’s office expecting to be offered LASIK and unaware that other options exist. All else being equal, it is sometimes easier for a doctor to simply agree","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"231 - 232"},"PeriodicalIF":0.7,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43843366","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 : 2022-07-04DOI: 10.1080/17469899.2022.2100763
S. Boneva, Julian Wolf, Peter Wieghofer, J. Sebag, C. Lange
ABSTRACT Introduction Vitreous hyalocyte functions have only recently been explored in-depth. These macrophage-like cells play critical roles in immunologic surveillance and physiology of the developing and adult eye. Areas covered Hyaloid vasculature involution during embryogenesis, synthesis and degradation of vitreous components during development and aging, and maintenance of vitreous transparency will be discussed. This article also reviews immunologic features during development and in the adult. Expert opinion Recent transcriptional analyses have demonstrated that despite similarity to other myeloid cell populations such as microglia and monocyte-derived macrophages, hyalocytes possess a distinct expression profile and molecular signature. Hyalocytes are important in hyaloid vasculature involution during development, ocular immune privilege and immune surveillance, synthesis and degradation of vitreous components, as well as migration and phagocytic activity during adulthood.
{"title":"Hyalocyte functions and immunology","authors":"S. Boneva, Julian Wolf, Peter Wieghofer, J. Sebag, C. Lange","doi":"10.1080/17469899.2022.2100763","DOIUrl":"https://doi.org/10.1080/17469899.2022.2100763","url":null,"abstract":"ABSTRACT Introduction Vitreous hyalocyte functions have only recently been explored in-depth. These macrophage-like cells play critical roles in immunologic surveillance and physiology of the developing and adult eye. Areas covered Hyaloid vasculature involution during embryogenesis, synthesis and degradation of vitreous components during development and aging, and maintenance of vitreous transparency will be discussed. This article also reviews immunologic features during development and in the adult. Expert opinion Recent transcriptional analyses have demonstrated that despite similarity to other myeloid cell populations such as microglia and monocyte-derived macrophages, hyalocytes possess a distinct expression profile and molecular signature. Hyalocytes are important in hyaloid vasculature involution during development, ocular immune privilege and immune surveillance, synthesis and degradation of vitreous components, as well as migration and phagocytic activity during adulthood.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"249 - 262"},"PeriodicalIF":0.7,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48429843","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 : 2022-07-04DOI: 10.1080/17469899.2022.2118715
Kiyoung Kim, E. Kim, Do Gyun Kim, Seung-Young Yu
ABSTRACT Purpose To evaluate the efficacy and safety of intravitreal dexamethasone (DEX) implantation for diabetic macular edema (DME) that proved unresponsive to previous anti-vascular endothelial growth factor (VEGF) treatment. Methods This prospective interventional study recruited 91 patients with refractory DME after previous anti-VEGF treatments in one or both eyes. All patients were followed up for at least 12 months. Best-corrected visual acuity (BCVA), central subfield thickness (CST) and macular volume were measured. Results Over the 12 months, a mean of 2.1 ± 0.8 DEX implantations were administered per eye; 26 eyes (28.9%) received 1 implantation, 31 (34.4%) received 2, and 34 (36.7%) received 3. BCVA was significantly improved in the first 6 months, from 54.8 to 59.5 letters. Both CST and macular volume decreased significantly after DEX implantation and maintained these improvements for at least 12 months. Subjects who needed the second DEX implantation had a greater number of prior anti-VEGF injections than did those who needed only one implantation (6.0 vs 3.0). Conclusions Two-thirds of refractory DME required less than two DEX implantations to maintain a dry macula for 12 months. Early switching to intravitreal DEX can be considered as the second-line therapeutic option, especially during the COVID-19 pandemic.
摘要目的评价玻璃体内地塞米松（DEX）植入治疗糖尿病黄斑水肿（DME）的疗效和安全性，该水肿对先前的抗血管内皮生长因子（VEGF）治疗无效。方法本前瞻性介入研究招募了91例单眼或双眼接受过抗VEGF治疗的难治性DME患者。所有患者均接受了至少12个月的随访。测量最佳矫正视力（BCVA）、中心亚视野厚度（CST）和黄斑体积。结果在12个月内，平均每只眼睛植入2.1±0.8个DEX；26眼（28.9%）接受了1次植入，31眼（34.4%）接受了2次植入，34眼（36.7%）接受了3次植入。BCVA在前6个月显著改善，从54.8个字母增加到59.5个字母。DEX植入后，CST和黄斑体积均显著下降，并保持这些改善至少12个月。与只需要一次植入的受试者相比，需要第二次DEX植入的受受试者之前注射过更多的抗VEGF药物（6.0 vs 3.0）。结论三分之二的难治性DME需要少于两次的DEX植入才能维持干燥黄斑12个月。早期改用玻璃体内DEX可被视为二线治疗选择，尤其是在新冠肺炎大流行期间。
{"title":"The effect of intravitreal dexamethasone implantation on diabetic macular edema refractory to anti-vascular endothelial growth factor treatment","authors":"Kiyoung Kim, E. Kim, Do Gyun Kim, Seung-Young Yu","doi":"10.1080/17469899.2022.2118715","DOIUrl":"https://doi.org/10.1080/17469899.2022.2118715","url":null,"abstract":"ABSTRACT Purpose To evaluate the efficacy and safety of intravitreal dexamethasone (DEX) implantation for diabetic macular edema (DME) that proved unresponsive to previous anti-vascular endothelial growth factor (VEGF) treatment. Methods This prospective interventional study recruited 91 patients with refractory DME after previous anti-VEGF treatments in one or both eyes. All patients were followed up for at least 12 months. Best-corrected visual acuity (BCVA), central subfield thickness (CST) and macular volume were measured. Results Over the 12 months, a mean of 2.1 ± 0.8 DEX implantations were administered per eye; 26 eyes (28.9%) received 1 implantation, 31 (34.4%) received 2, and 34 (36.7%) received 3. BCVA was significantly improved in the first 6 months, from 54.8 to 59.5 letters. Both CST and macular volume decreased significantly after DEX implantation and maintained these improvements for at least 12 months. Subjects who needed the second DEX implantation had a greater number of prior anti-VEGF injections than did those who needed only one implantation (6.0 vs 3.0). Conclusions Two-thirds of refractory DME required less than two DEX implantations to maintain a dry macula for 12 months. Early switching to intravitreal DEX can be considered as the second-line therapeutic option, especially during the COVID-19 pandemic.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"281 - 287"},"PeriodicalIF":0.7,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41561313","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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