Pub Date : 2022-07-04DOI: 10.1080/17469899.2022.2108790
Medhat A Bakr, Ussama A Moustafa, Majed Al-Subaie, Mohammed A Alfayyadh
ABSTRACT Background Childhood glaucoma is considered one of the main causes of irreversible blindness. Primary congenital glaucoma (PCG) is a rare disease; however, in Middle East countries such as Saudi Arabia, the incidence is high. Research design and methods A retrospective study was conducted at Dhahran Eye Specialist Hospital from September 2016 to March 2020 to evaluate the efficacy and safety of transscleral micropulse cyclophotocoagulation (TS-MPCPC) as a primary procedure in congenital glaucoma and as an adjuvant to prepare the patient for ultimate surgical intervention. Emergent ophthalmic examination under sedation or general anesthesia was done to evaluate the presence of PCG features, measure the intraocular pressure (IOP), horizontal corneal diameter (HCD), and to evaluate the optic disc. Results Twenty-one eyes were included in the study. Cup to disc ratio (CDR) was not decreased postoperatively, and it was found statistically non-significant. There was statistically significant decrease in IOP and horizontal corneal diameter (HCD) (p < 0.001, 0.014), respectively. The mean reduction in IOP was 36%. The final IOP was between 5 and 21 mmHg in all cases. Qualified success was achieved in 17 (81%) eyes and 4 (19%) eyes had surgical failure. Conclusion TS-MPCPC might have effective and safe implications for congenital glaucoma patients.
{"title":"The role trans-sclera MP-CPC as a primary treatment option in congenital glaucoma management","authors":"Medhat A Bakr, Ussama A Moustafa, Majed Al-Subaie, Mohammed A Alfayyadh","doi":"10.1080/17469899.2022.2108790","DOIUrl":"https://doi.org/10.1080/17469899.2022.2108790","url":null,"abstract":"ABSTRACT Background Childhood glaucoma is considered one of the main causes of irreversible blindness. Primary congenital glaucoma (PCG) is a rare disease; however, in Middle East countries such as Saudi Arabia, the incidence is high. Research design and methods A retrospective study was conducted at Dhahran Eye Specialist Hospital from September 2016 to March 2020 to evaluate the efficacy and safety of transscleral micropulse cyclophotocoagulation (TS-MPCPC) as a primary procedure in congenital glaucoma and as an adjuvant to prepare the patient for ultimate surgical intervention. Emergent ophthalmic examination under sedation or general anesthesia was done to evaluate the presence of PCG features, measure the intraocular pressure (IOP), horizontal corneal diameter (HCD), and to evaluate the optic disc. Results Twenty-one eyes were included in the study. Cup to disc ratio (CDR) was not decreased postoperatively, and it was found statistically non-significant. There was statistically significant decrease in IOP and horizontal corneal diameter (HCD) (p < 0.001, 0.014), respectively. The mean reduction in IOP was 36%. The final IOP was between 5 and 21 mmHg in all cases. Qualified success was achieved in 17 (81%) eyes and 4 (19%) eyes had surgical failure. Conclusion TS-MPCPC might have effective and safe implications for congenital glaucoma patients.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"289 - 294"},"PeriodicalIF":0.7,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47720121","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: 10.1080/17469899.2022.2124969
F. Kuhn
It is not a pretty picture. Today we have the finest tools for diagnostics and a full armamentarium of therapeutics including intraocular drugs, temporary keratoprosetheses (TKP), vitrectomy equipment and instruments; yet more and more patients find out that what determines their fate is indeed fate. Does the facility where s/he is taken keep its operationroom doors open afterhours? Even if yes, is the available staff well trained and all necessary tools accessible? In this publication I summarize my personal opinion regarding the decisions to be made for patients presenting with an open globe injury (OGI) – assuming that the facility is a 24/7 one with all the required logistics/infrastructure being optimal. This also means that the physician to make the decisions and perform the surgery is not an untrained, young resident (as unfortunately so often the case is) but a surgeon experienced in both ‘segments’ of the eye: i.e. a vitreoretinal specialist. If these criteria are not fulfilled, it may be preferable to transport/refer the patient to a different facility where conditions allow optimal treatment. Roughly half of eyes with an OGI require surgery on the posterior segment; if these pathologies cannot be addressed by the surgeon closing the wound, the delay may lead to irreversible damage.
{"title":"Decision-making when your patient has an open globe injury","authors":"F. Kuhn","doi":"10.1080/17469899.2022.2124969","DOIUrl":"https://doi.org/10.1080/17469899.2022.2124969","url":null,"abstract":"It is not a pretty picture. Today we have the finest tools for diagnostics and a full armamentarium of therapeutics including intraocular drugs, temporary keratoprosetheses (TKP), vitrectomy equipment and instruments; yet more and more patients find out that what determines their fate is indeed fate. Does the facility where s/he is taken keep its operationroom doors open afterhours? Even if yes, is the available staff well trained and all necessary tools accessible? In this publication I summarize my personal opinion regarding the decisions to be made for patients presenting with an open globe injury (OGI) – assuming that the facility is a 24/7 one with all the required logistics/infrastructure being optimal. This also means that the physician to make the decisions and perform the surgery is not an untrained, young resident (as unfortunately so often the case is) but a surgeon experienced in both ‘segments’ of the eye: i.e. a vitreoretinal specialist. If these criteria are not fulfilled, it may be preferable to transport/refer the patient to a different facility where conditions allow optimal treatment. Roughly half of eyes with an OGI require surgery on the posterior segment; if these pathologies cannot be addressed by the surgeon closing the wound, the delay may lead to irreversible damage.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"227 - 229"},"PeriodicalIF":0.7,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48321212","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: 10.1080/17469899.2022.2101449
S. Young, Nikhil Jain, A. Tatham
ABSTRACT Introduction Imaging technologies, especially optical coherence tomography (OCT), have an important role in glaucoma diagnosis and monitoring. This review aims to critically appraise recent developments in imaging of the optic nerve head (ONH), retinal nerve fiber layer (RNFL), and macula in glaucoma. Areas covered The review focuses on imaging of the ONH, retina, and associated structures, identifying five broad themes; 1) imaging of the RNFL, ONH and macula; 2) OCT angiography (OCTA); 3) structure function analysis; 4) novel methods of retinal imaging (beyond OCT and OCTA); and 5) artificial intelligence (AI). The use of imaging for glaucoma diagnosis and progression analysis is discussed. Expert opinion Measurements of RNFL, macular, and ONH have shown similar ability to detect glaucoma, though the majority of OCT diagnostic ability studies are limited by case-control design. Macular and ONH parameters such as Bruch’s membrane opening-minimum rim width (BMO-MRW) may be more useful in eyes with unusual optic disc appearance or high myopia, though the limitations of normative reference databases should be appreciated. Imaging should not replace perimetry, particularly for monitoring progression. Devices are likely to be developed that test structure and function concurrently, with results integrated using Bayesian statistical approaches.
{"title":"The application of advanced imaging techniques in glaucoma","authors":"S. Young, Nikhil Jain, A. Tatham","doi":"10.1080/17469899.2022.2101449","DOIUrl":"https://doi.org/10.1080/17469899.2022.2101449","url":null,"abstract":"ABSTRACT Introduction Imaging technologies, especially optical coherence tomography (OCT), have an important role in glaucoma diagnosis and monitoring. This review aims to critically appraise recent developments in imaging of the optic nerve head (ONH), retinal nerve fiber layer (RNFL), and macula in glaucoma. Areas covered The review focuses on imaging of the ONH, retina, and associated structures, identifying five broad themes; 1) imaging of the RNFL, ONH and macula; 2) OCT angiography (OCTA); 3) structure function analysis; 4) novel methods of retinal imaging (beyond OCT and OCTA); and 5) artificial intelligence (AI). The use of imaging for glaucoma diagnosis and progression analysis is discussed. Expert opinion Measurements of RNFL, macular, and ONH have shown similar ability to detect glaucoma, though the majority of OCT diagnostic ability studies are limited by case-control design. Macular and ONH parameters such as Bruch’s membrane opening-minimum rim width (BMO-MRW) may be more useful in eyes with unusual optic disc appearance or high myopia, though the limitations of normative reference databases should be appreciated. Imaging should not replace perimetry, particularly for monitoring progression. Devices are likely to be developed that test structure and function concurrently, with results integrated using Bayesian statistical approaches.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"183 - 197"},"PeriodicalIF":0.7,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45575561","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: 10.1080/17469899.2022.2098717
Didrika S. van de Wouw, Bram de Jong, I. van der Meulen, T. van den Berg
ABSTRACT Aim To quantify visual complaints by determining straylight values, to investigate the angular dependency of straylight, and to examine the use of straylight for clinical decision making in fish-eye disease (FED) patients. Research design and methods Straylight was measured in 10 patients with FED using the compensation comparison method (Oculus C-Quant). Additionally, the direct comparison method was used for four patients to measure straylight at different visual angles. Results Average straylight in untreated eyes with FED was 1.91 log(s). Penetrating keratoplasty and deep anterior Lamellar keratoplasty treated eyes had average straylight levels of 1.53 log(s) and 1.63 log(s), respectively. Straylight in FED was not strongly angle dependent. Conclusions Straylight was highly elevated (up to 24x age normal value) although visual acuity was relatively well preserved. For several patients, complaints were severe enough to undergo corneal transplantation resulting in reduced straylight and alleviation of complaints. Straylight in FED follows relatively normal angular dependence. We conclude that straylight measurements can support clinical decision-making by quantifying complaints about reduced visual quality, even if visual acuity remains normal.
{"title":"Straylight in fish-eye disease: visual quality and angular dependence of straylight","authors":"Didrika S. van de Wouw, Bram de Jong, I. van der Meulen, T. van den Berg","doi":"10.1080/17469899.2022.2098717","DOIUrl":"https://doi.org/10.1080/17469899.2022.2098717","url":null,"abstract":"ABSTRACT Aim To quantify visual complaints by determining straylight values, to investigate the angular dependency of straylight, and to examine the use of straylight for clinical decision making in fish-eye disease (FED) patients. Research design and methods Straylight was measured in 10 patients with FED using the compensation comparison method (Oculus C-Quant). Additionally, the direct comparison method was used for four patients to measure straylight at different visual angles. Results Average straylight in untreated eyes with FED was 1.91 log(s). Penetrating keratoplasty and deep anterior Lamellar keratoplasty treated eyes had average straylight levels of 1.53 log(s) and 1.63 log(s), respectively. Straylight in FED was not strongly angle dependent. Conclusions Straylight was highly elevated (up to 24x age normal value) although visual acuity was relatively well preserved. For several patients, complaints were severe enough to undergo corneal transplantation resulting in reduced straylight and alleviation of complaints. Straylight in FED follows relatively normal angular dependence. We conclude that straylight measurements can support clinical decision-making by quantifying complaints about reduced visual quality, even if visual acuity remains normal.","PeriodicalId":39989,"journal":{"name":"Expert Review of Ophthalmology","volume":"17 1","pages":"221 - 225"},"PeriodicalIF":0.7,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44039692","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: 10.1080/17469899.2022.2079496
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: 10.1080/17469899.2022.2111302
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 : 2022-05-04DOI: 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 : 2022-03-04DOI: 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}
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