Pub Date : 2022-05-04DOI: 10.1080/17469899.2022.2079496
D. Hurley, S. Neary
ABSTRACT Background Increasing numbers of patients are being referred to dedicated eye emergency departments, many of whom have non-acute issues. The aim of this study was to assess the most commonly referred conditions to an eye emergency department. Methods A retrospective phone triage referral and clinical note audit was performed to assess the frequency of each condition referred to the ophthalmology emergency department over a two-month period. Diagnoses were grouped under headings to assess the volume of each sub-specialty referrals. Results 1700 patients referred to the eye emergency department were analyzed. The most commonly referred conditions were corneal foreign bodies (191), posterior vitreous detachments (101), and keratitis (87). The most commonly implicated categories were anterior segment (700), vitreoretinal (250), and adnexal & oculoplastics (247). 35.6% of patients (605/1,700) were referred on to an outpatients clinic. Seventy-five time-sensitive emergencies were identified, comprising 4.4% of all presentations. Conclusion The frequency of conditions seen in our eye emergency department may closely reflect the prevalence of acute ophthalmic presentations. This study displays the wide range of conditions that are referred. This knowledge may assist in resource allocation and training of junior ophthalmologists.
{"title":"An analysis of the conditions referred to an eye emergency department","authors":"D. Hurley, S. Neary","doi":"10.1080/17469899.2022.2079496","DOIUrl":"https://doi.org/10.1080/17469899.2022.2079496","url":null,"abstract":"ABSTRACT Background Increasing numbers of patients are being referred to dedicated eye emergency departments, many of whom have non-acute issues. The aim of this study was to assess the most commonly referred conditions to an eye emergency department. Methods A retrospective phone triage referral and clinical note audit was performed to assess the frequency of each condition referred to the ophthalmology emergency department over a two-month period. Diagnoses were grouped under headings to assess the volume of each sub-specialty referrals. Results 1700 patients referred to the eye emergency department were analyzed. The most commonly referred conditions were corneal foreign bodies (191), posterior vitreous detachments (101), and keratitis (87). The most commonly implicated categories were anterior segment (700), vitreoretinal (250), and adnexal & oculoplastics (247). 35.6% of patients (605/1,700) were referred on to an outpatients clinic. Seventy-five time-sensitive emergencies were identified, comprising 4.4% of all presentations. Conclusion The frequency of conditions seen in our eye emergency department may closely reflect the prevalence of acute ophthalmic presentations. This study displays the wide range of conditions that are referred. This knowledge may assist in resource allocation and training of junior ophthalmologists.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"211 - 216"},"PeriodicalIF":0.7,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46416326","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 : 2022-05-04DOI: 10.1080/17469899.2022.2108406
M. Parravano, S. Fragiotta, G. Querques
Optical coherence tomography angiography (OCTA) enables visualization of the retinal capillary plexus structure at various depths, identifying flow density and microaneurysms from the deep capillary plexus (DCP) in diabetic retinopathy (DR) beyond the ability of fluorescein angiography (FA) [1,2]. Diabetic macular edema (DME) is one of the leading causes of vision loss in diabetic patients with a variable and temporary improvement in response to treatment [3]. In this scenario, recognizing particular OCTA features is crucial for identifying the prediction of DME that can be of paramount importance to establishing a better glycometabolic control and thus preventing DME development. Indeed, DME eyes with macular center involvement retaining a good visual acuity of 20/25 letters or better showed no significant differences in vision loss at 2 years in patients managed with aflibercept, laser photocoagulation, or observation [4]. In addition, another important role of OCTA consists in predicting the responsiveness to treatment [5].
{"title":"Prognostic relevance of optical coherence tomography angiography biomarkers in diabetic macular edema","authors":"M. Parravano, S. Fragiotta, G. Querques","doi":"10.1080/17469899.2022.2108406","DOIUrl":"https://doi.org/10.1080/17469899.2022.2108406","url":null,"abstract":"Optical coherence tomography angiography (OCTA) enables visualization of the retinal capillary plexus structure at various depths, identifying flow density and microaneurysms from the deep capillary plexus (DCP) in diabetic retinopathy (DR) beyond the ability of fluorescein angiography (FA) [1,2]. Diabetic macular edema (DME) is one of the leading causes of vision loss in diabetic patients with a variable and temporary improvement in response to treatment [3]. In this scenario, recognizing particular OCTA features is crucial for identifying the prediction of DME that can be of paramount importance to establishing a better glycometabolic control and thus preventing DME development. Indeed, DME eyes with macular center involvement retaining a good visual acuity of 20/25 letters or better showed no significant differences in vision loss at 2 years in patients managed with aflibercept, laser photocoagulation, or observation [4]. In addition, another important role of OCTA consists in predicting the responsiveness to treatment [5].","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"161 - 163"},"PeriodicalIF":0.7,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41346826","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 : 2022-05-04DOI: 10.1080/17469899.2022.2101998
Liam M Grover, R. Moakes, S. Rauz
ABSTRACT Introduction Eye drops play a prominent role in the treatment and/or management of many ocular diseases, however, they often have limitations. It is recognized that new therapies are needed in this area, to improve patient care. Areas covered This manuscript discusses a novel class of materials, known as fluid gels, for their ability to improve ocular care. The paper focuses on how the materials address several key limitations to eye drops, such as longevity, lubrication, and delivery. Expert opinion Eye drops are a common source of treatment/management for many ocular diseases. However, lacking the complexity of the native tear, they often fail to hit the mark in terms of performance. In particular, the longevity of many drops and ocular lubricants is insufficient to keep active compounds in situ and/or offer adequate treatment. Fluid gels have high prospects in this area; as careful control over their microstructures provides a platform that can be applied to the ocular surface for in the order of hours. Not only can retention be finely tuned, but such materials also offer highly lubricating properties. Excitingly, promising pre-clinical data, coupled with the means to manufacture at scale, offers a tantalizing new prospect for the future of ocular treatments.
{"title":"Innovations in fluid-gel eye drops for treating disease of the eye: prospects for enhancing drug retention and reducing corneal scarring","authors":"Liam M Grover, R. Moakes, S. Rauz","doi":"10.1080/17469899.2022.2101998","DOIUrl":"https://doi.org/10.1080/17469899.2022.2101998","url":null,"abstract":"ABSTRACT Introduction Eye drops play a prominent role in the treatment and/or management of many ocular diseases, however, they often have limitations. It is recognized that new therapies are needed in this area, to improve patient care. Areas covered This manuscript discusses a novel class of materials, known as fluid gels, for their ability to improve ocular care. The paper focuses on how the materials address several key limitations to eye drops, such as longevity, lubrication, and delivery. Expert opinion Eye drops are a common source of treatment/management for many ocular diseases. However, lacking the complexity of the native tear, they often fail to hit the mark in terms of performance. In particular, the longevity of many drops and ocular lubricants is insufficient to keep active compounds in situ and/or offer adequate treatment. Fluid gels have high prospects in this area; as careful control over their microstructures provides a platform that can be applied to the ocular surface for in the order of hours. Not only can retention be finely tuned, but such materials also offer highly lubricating properties. Excitingly, promising pre-clinical data, coupled with the means to manufacture at scale, offers a tantalizing new prospect for the future of ocular treatments.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"175 - 181"},"PeriodicalIF":0.7,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48258488","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 : 2022-05-04DOI: 10.1080/17469899.2022.2096589
Daiane Beutinger, Cristiano Caixeta-Umbelino, N. Kasahara
ABSTRACT Background To assess the possible effect of the coronavirus disease 2019 (COVID-19) pandemic on the progression of visual field in glaucoma patients attending a charity hospital in Sao Paulo, Brazil. Research design and methods This retrospective study included all glaucoma patients attending the Glaucoma Service Santa Casa of Sao Paulo from July 2019 to October 2021. Data retrieved from the charts included intraocular pressure (IOP), information about missing appointments and non-adherence to medical treatment, mean deviation (MD), and pattern standard deviation (PSD) of Humphrey visual field. Pre- and late in-pandemic data were compared with the Wilcoxon signed-rank test. Results There was no statistically significant difference between pre- and in-pandemic values of MD, and PSD values (all P > 0.05). Fifty eyes (27.9%) of 36 patients (36%) revealed an −2 dB decrease in the MD value. Conclusions The COVID-19 pandemic did not affect visual field progression in most of patients. However, about a third of patients presented a decrease in the MD value >-2 dB in at least one eye especially those with advanced disease. As a slowly progressive optic neuropathy, the two-year time of the pandemic was possibly not long enough to impact negatively on the glaucoma progression in most of patients.
{"title":"Visual field changes in glaucoma patients during the coronavirus disease 2019 pandemic in a middle-income country","authors":"Daiane Beutinger, Cristiano Caixeta-Umbelino, N. Kasahara","doi":"10.1080/17469899.2022.2096589","DOIUrl":"https://doi.org/10.1080/17469899.2022.2096589","url":null,"abstract":"ABSTRACT Background To assess the possible effect of the coronavirus disease 2019 (COVID-19) pandemic on the progression of visual field in glaucoma patients attending a charity hospital in Sao Paulo, Brazil. Research design and methods This retrospective study included all glaucoma patients attending the Glaucoma Service Santa Casa of Sao Paulo from July 2019 to October 2021. Data retrieved from the charts included intraocular pressure (IOP), information about missing appointments and non-adherence to medical treatment, mean deviation (MD), and pattern standard deviation (PSD) of Humphrey visual field. Pre- and late in-pandemic data were compared with the Wilcoxon signed-rank test. Results There was no statistically significant difference between pre- and in-pandemic values of MD, and PSD values (all P > 0.05). Fifty eyes (27.9%) of 36 patients (36%) revealed an −2 dB decrease in the MD value. Conclusions The COVID-19 pandemic did not affect visual field progression in most of patients. However, about a third of patients presented a decrease in the MD value >-2 dB in at least one eye especially those with advanced disease. As a slowly progressive optic neuropathy, the two-year time of the pandemic was possibly not long enough to impact negatively on the glaucoma progression in most of patients.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"217 - 220"},"PeriodicalIF":0.7,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45603908","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 : 2022-05-04DOI: 10.1080/17469899.2022.2111302
Lia Meuthia Zaini, A. Kartasasmita, T. Gondhowiardjo, M. Syukri, R. Lesmana
ABSTRACT Introduction Sodium glucose co-transporter 2 (SGLT2) inhibitors are a new class of drugs for the treatment of type 2 diabetes mellitus (T2DM), which have cardio-renal protective activity. Some studies have also found that this drug may have an eye-protective effect, especially in preventing diabetic retinopathy (DR). Areas covered A search was conducted on PubMed and Google Scholar for all articles published from January 2007 to May 2022. This paper provides a new insight into how new emerging diabetic therapy may be beneficial in the case of DR. SGLT2 inhibitors have been proven to delay DR progression. However, the drug mechanism in the pathophysiology of diabetic retinopathy has not yet been established. Expert opinion In clinical practice, using SGLT2 inhibitors is beneficial as it offers multiple advantages. They can control blood sugar levels while simultaneously suppressing the progression of DR and DME. There is potential that the use of other expensive and prolonged therapeutic modalities may no longer be necessary, reducing the burden of treatment for patients.
{"title":"Potential molecular mechanism of action of sodium-glucose co-transporter 2 inhibitors in the prevention and management of diabetic retinopathy","authors":"Lia Meuthia Zaini, A. Kartasasmita, T. Gondhowiardjo, M. Syukri, R. Lesmana","doi":"10.1080/17469899.2022.2111302","DOIUrl":"https://doi.org/10.1080/17469899.2022.2111302","url":null,"abstract":"ABSTRACT Introduction Sodium glucose co-transporter 2 (SGLT2) inhibitors are a new class of drugs for the treatment of type 2 diabetes mellitus (T2DM), which have cardio-renal protective activity. Some studies have also found that this drug may have an eye-protective effect, especially in preventing diabetic retinopathy (DR). Areas covered A search was conducted on PubMed and Google Scholar for all articles published from January 2007 to May 2022. This paper provides a new insight into how new emerging diabetic therapy may be beneficial in the case of DR. SGLT2 inhibitors have been proven to delay DR progression. However, the drug mechanism in the pathophysiology of diabetic retinopathy has not yet been established. Expert opinion In clinical practice, using SGLT2 inhibitors is beneficial as it offers multiple advantages. They can control blood sugar levels while simultaneously suppressing the progression of DR and DME. There is potential that the use of other expensive and prolonged therapeutic modalities may no longer be necessary, reducing the burden of treatment for patients.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"199 - 210"},"PeriodicalIF":0.7,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49176575","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: 10.1080/17469899.2022.2067145
T. Mimura
ABSTRACT Introduction Giant papillary conjunctivitis (GPC), which is the most severe type of contact lens–induced (CL) papillary conjunctivitis (CLPC), is an inflammatory condition of the upper tarsal conjunctiva. Major symptoms of CLPC include irritation, pain, itching, and redness of the ocular surface. Area covered This review provides an update on our current understanding of the pathogenesis and treatment of GPC. Expert opinion GPC is most often associated with the use of non-disposable soft contact lenses (SCL), or soft hydrogel lenses, and infrequent CL replacement. Patients with GPC may require both temporary cessation of CL wear and treatment with medications such as topical mast cell stabilizers, antihistamines, non-steroidal anti-inflammatory agents, or steroids.
{"title":"Allergic conjunctivitis in contact lens wearers: challenges and management recommendations","authors":"T. Mimura","doi":"10.1080/17469899.2022.2067145","DOIUrl":"https://doi.org/10.1080/17469899.2022.2067145","url":null,"abstract":"ABSTRACT Introduction Giant papillary conjunctivitis (GPC), which is the most severe type of contact lens–induced (CL) papillary conjunctivitis (CLPC), is an inflammatory condition of the upper tarsal conjunctiva. Major symptoms of CLPC include irritation, pain, itching, and redness of the ocular surface. Area covered This review provides an update on our current understanding of the pathogenesis and treatment of GPC. Expert opinion GPC is most often associated with the use of non-disposable soft contact lenses (SCL), or soft hydrogel lenses, and infrequent CL replacement. Patients with GPC may require both temporary cessation of CL wear and treatment with medications such as topical mast cell stabilizers, antihistamines, non-steroidal anti-inflammatory agents, or steroids.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"123 - 128"},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43924225","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: 10.1080/17469899.2022.2085557
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":"17 1","pages":"105 - 114"},"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: 10.1080/17469899.2022.2085558
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":"17 1","pages":"153 - 160"},"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: 10.1080/17469899.2022.2060821
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":"17 1","pages":"87 - 104"},"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: 10.1080/17469899.2022.2065984
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":"17 1","pages":"115 - 121"},"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}
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