Pub Date : 2023-01-01DOI: 10.17925/usor.2023.17.1.4
P. Ichhpujani, Sahil Thakur
There are several barriers to patient adherence in glaucoma treatment, such as complex dosing regimens, side effects and difficulties with eyedrop administration. This article discusses these challenges, and how they have led to the development of novel sustained-release platforms for glaucoma medications. These platforms include extraocular and intraocular options, such as wearable ocular surface devices, punctal plug systems, subconjunctival injections and intracameral implants. In particular, we focus on the iDose® TR (Glaukos, San Clemente, CA, USA) sustained-release travoprost titanium implant. It is a particularly promising option, which continuously elutes travoprost at therapeutic levels over an extended period. Phase III trial results have shown its efficacy in lowering intraocular pressure. Notably, the implant typically lasts for around 4–5 years and can be safely exchanged with a new one after it finishes its therapeutic effect. This advancement in glaucoma treatment offers a new alternative to traditional treatment modalities. Real-world trials are needed to shed more light on the efficacy and safety profile of iDose TR.
患者坚持青光眼治疗存在一些障碍，如复杂的给药方案、副作用和眼药水给药困难。本文讨论了这些挑战，以及它们如何导致新型青光眼药物缓释平台的发展。这些平台包括眼外和眼内选择，如可穿戴眼表装置、点塞系统、结膜下注射和眼内植入物。我们特别关注iDose®TR (Glaukos, San Clemente, CA, USA)缓释曲沃前列素钛种植体。这是一个特别有前途的选择，它可以在较长时间内持续洗脱曲伏前列素的治疗水平。III期临床试验结果显示其具有降低眼压的疗效。值得注意的是，植入物通常持续约4-5年，并且在治疗效果结束后可以安全地更换新的植入物。青光眼治疗的这一进展为传统治疗方式提供了一种新的选择。需要真实世界的试验来更多地阐明iDose TR的有效性和安全性。
{"title":"iDose TR Sustained-release Travoprost Implant for the Treatment of Glaucoma","authors":"P. Ichhpujani, Sahil Thakur","doi":"10.17925/usor.2023.17.1.4","DOIUrl":"https://doi.org/10.17925/usor.2023.17.1.4","url":null,"abstract":"There are several barriers to patient adherence in glaucoma treatment, such as complex dosing regimens, side effects and difficulties with eyedrop administration. This article discusses these challenges, and how they have led to the development of novel sustained-release platforms for glaucoma medications. These platforms include extraocular and intraocular options, such as wearable ocular surface devices, punctal plug systems, subconjunctival injections and intracameral implants. In particular, we focus on the iDose® TR (Glaukos, San Clemente, CA, USA) sustained-release travoprost titanium implant. It is a particularly promising option, which continuously elutes travoprost at therapeutic levels over an extended period. Phase III trial results have shown its efficacy in lowering intraocular pressure. Notably, the implant typically lasts for around 4–5 years and can be safely exchanged with a new one after it finishes its therapeutic effect. This advancement in glaucoma treatment offers a new alternative to traditional treatment modalities. Real-world trials are needed to shed more light on the efficacy and safety profile of iDose TR.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.17925/usor.2023.17.1.10
W. Shalaby, M. Moster
Minimally invasive glaucoma surgery procedures are newly developed surgical modalities for the management of glaucoma. Their target is to lower intraocular pressure with minimal eye trauma and fewer complications. The first-generation iStent® (Glaukos Corp, Laguna Hills, CA, USA) is the first minimally invasive glaucoma surgery device to be approved for the treatment of open-angle glaucoma. It allows aqueous humour to be drained directly from the anterior chamber to Schlemm’s canal, bypassing the trabecular meshwork, which is believed to be the main site of outflow resistance. The second-generation iStent inject® (Glaukos Corp, Laguna Hills, CA, USA) is a smaller implant that allows simultaneous implantation of two stents, which could theoretically result in lower intraocular pressure. The Hydrus® Microstent (Alcon, Geneva, Switzerland) is another trabecular implant that dilates and scaffolds Schlemm’s canal. This articles reviews publications about all trabecular meshwork bypass stents, comparing them in terms of their efficacy and safety.
微创青光眼手术是青光眼治疗的新发展的手术方式。他们的目标是降低眼压，同时减少眼部创伤和并发症。第一代iStent®(Glaukos Corp, Laguna Hills, CA, USA)是第一个被批准用于治疗开角型青光眼的微创青光眼手术设备。它允许房水直接从前房排出到施莱姆管，绕过小梁网，小梁网被认为是流出阻力的主要部位。第二代iStent注射剂®(Glaukos Corp, Laguna Hills, CA, USA)是一种更小的植入物，可以同时植入两个支架，理论上可以降低眼压。Hydrus®微支架(爱尔康，日内瓦，瑞士)是另一种小梁植入物，用于扩张和支架施莱姆氏管。本文回顾了所有小梁网旁路支架的文献，比较了它们的有效性和安全性。
{"title":"New and Emerging Trabecular Meshwork Bypass Stents","authors":"W. Shalaby, M. Moster","doi":"10.17925/usor.2023.17.1.10","DOIUrl":"https://doi.org/10.17925/usor.2023.17.1.10","url":null,"abstract":"Minimally invasive glaucoma surgery procedures are newly developed surgical modalities for the management of glaucoma. Their target is to lower intraocular pressure with minimal eye trauma and fewer complications. The first-generation iStent® (Glaukos Corp, Laguna Hills, CA, USA) is the first minimally invasive glaucoma surgery device to be approved for the treatment of open-angle glaucoma. It allows aqueous humour to be drained directly from the anterior chamber to Schlemm’s canal, bypassing the trabecular meshwork, which is believed to be the main site of outflow resistance. The second-generation iStent inject® (Glaukos Corp, Laguna Hills, CA, USA) is a smaller implant that allows simultaneous implantation of two stents, which could theoretically result in lower intraocular pressure. The Hydrus® Microstent (Alcon, Geneva, Switzerland) is another trabecular implant that dilates and scaffolds Schlemm’s canal. This articles reviews publications about all trabecular meshwork bypass stents, comparing them in terms of their efficacy and safety.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.17925/usor.2023.17.2.1
A. Arrigo, E. Aragona, F. Bandello
Artificial intelligence (AI) is becoming established as a new method for analysing ophthalmological data, and unveiling new clinical and pathogenic insights into retinal diseases. AI-based algorithms are largely employed in the field of the most prevalent retinal diseases, including diabetic retinopathy, age-related macular degeneration and myopia. Several research groups are also testing AI in other retinal diseases, including inherited retinal dystrophies, retinopathy of prematurity, central serous chorioretinopathy and retinal vein occlusion. AI models are mainly used in screening of the fundus and structural optical coherence tomography images. However, more advanced methodologies are under investigation to extract clinically relevant information regarding the biomarkers of disease activity and outcome measures. AI is a powerful tool for increasing the amount of information obtained in clinical and research contexts. However, many issues still need addressing, including the resulting high demand for technology and resources, and the need for very large databases. Moreover, several ethical issues require debate, and specific rules are needed to govern the use of AI algorithms and check the quality of the analysed data. This article reviews the current use of AI in retinal diseases, unmet needs and future perspectives.
{"title":"Artificial Intelligence for the Diagnosis and Screening of Retinal Diseases","authors":"A. Arrigo, E. Aragona, F. Bandello","doi":"10.17925/usor.2023.17.2.1","DOIUrl":"https://doi.org/10.17925/usor.2023.17.2.1","url":null,"abstract":"Artificial intelligence (AI) is becoming established as a new method for analysing ophthalmological data, and unveiling new clinical and pathogenic insights into retinal diseases. AI-based algorithms are largely employed in the field of the most prevalent retinal diseases, including diabetic retinopathy, age-related macular degeneration and myopia. Several research groups are also testing AI in other retinal diseases, including inherited retinal dystrophies, retinopathy of prematurity, central serous chorioretinopathy and retinal vein occlusion. AI models are mainly used in screening of the fundus and structural optical coherence tomography images. However, more advanced methodologies are under investigation to extract clinically relevant information regarding the biomarkers of disease activity and outcome measures. AI is a powerful tool for increasing the amount of information obtained in clinical and research contexts. However, many issues still need addressing, including the resulting high demand for technology and resources, and the need for very large databases. Moreover, several ethical issues require debate, and specific rules are needed to govern the use of AI algorithms and check the quality of the analysed data. This article reviews the current use of AI in retinal diseases, unmet needs and future perspectives.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.17925/usor.2023.17.1.36
Uma Balakrishnan, Samantha M Arsenault, Sumitra S. Khandelwal
Neurotrophic keratitis is a complex condition with a variety of aetiologies involving damage to the sensory nerves that innervate the cornea, resulting in potentially devastating ocular surface disease. Aetiologies include diabetes, prior herpesvirus keratitis, stroke or compressive damage to the trigeminal nerve, chronic ocular surface disease or contact lens overuse, among others. Management is multidisciplinary; of course, the underlying condition must be addressed and treated. The ocular surface must be stabilized, and depending on the severity, treatment options include artificial tears and lubrication, protective barriers (scleral lens, tarsorrhaphy), and growth factors that promote healing (serum tears, amniotic membrane). Finally, treatment can target restoration of corneal sensory innervation (cenegermin, corneal neurotization). Early recognition and treatment are important factors in reducing vision loss and long-term complications from neurotrophic keratitis.
{"title":"Neurotrophic Keratitis: Exploring the Therapeutic Landscape","authors":"Uma Balakrishnan, Samantha M Arsenault, Sumitra S. Khandelwal","doi":"10.17925/usor.2023.17.1.36","DOIUrl":"https://doi.org/10.17925/usor.2023.17.1.36","url":null,"abstract":"Neurotrophic keratitis is a complex condition with a variety of aetiologies involving damage to the sensory nerves that innervate the cornea, resulting in potentially devastating ocular surface disease. Aetiologies include diabetes, prior herpesvirus keratitis, stroke or compressive damage to the trigeminal nerve, chronic ocular surface disease or contact lens overuse, among others. Management is multidisciplinary; of course, the underlying condition must be addressed and treated. The ocular surface must be stabilized, and depending on the severity, treatment options include artificial tears and lubrication, protective barriers (scleral lens, tarsorrhaphy), and growth factors that promote healing (serum tears, amniotic membrane). Finally, treatment can target restoration of corneal sensory innervation (cenegermin, corneal neurotization). Early recognition and treatment are important factors in reducing vision loss and long-term complications from neurotrophic keratitis.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.17925/usor.2023.17.1.25
Mohammad Jourieh
Suprachoroidal injection is a unique, minimally invasive procedure for drug delivery to the posterior segment of the eye. Drugs can be delivered easily via microneedles that are slightly longer than the scleral and conjunctival thickness at pars plana. Suprachoroidal delivery of corticosteroids allows higher steroid concentration in the posterior segment tissues with minimal drug concentration in the anterior segment, which decreases the risk of other adverse ocular events like steroid-induced elevation of intraocular pressure and cataract progression. Several clinical trials have evaluated the safety and efficacy of suprachoroidal injection of triamcinolone acetonide in various ocular conditions. This article reviews the novel treatment as a promising route for drug delivery.
{"title":"Safety and Efficacy of Suprachorodial Injection of Triamcinolone Acetonide: Review of a Novel Treatment","authors":"Mohammad Jourieh","doi":"10.17925/usor.2023.17.1.25","DOIUrl":"https://doi.org/10.17925/usor.2023.17.1.25","url":null,"abstract":"Suprachoroidal injection is a unique, minimally invasive procedure for drug delivery to the posterior segment of the eye. Drugs can be delivered easily via microneedles that are slightly longer than the scleral and conjunctival thickness at pars plana. Suprachoroidal delivery of corticosteroids allows higher steroid concentration in the posterior segment tissues with minimal drug concentration in the anterior segment, which decreases the risk of other adverse ocular events like steroid-induced elevation of intraocular pressure and cataract progression. Several clinical trials have evaluated the safety and efficacy of suprachoroidal injection of triamcinolone acetonide in various ocular conditions. This article reviews the novel treatment as a promising route for drug delivery.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.17925/usor.2023.17.1.42
Jacob Duker, Priya Vakharia, J. Duker, L. Rifkin, C. Shah
Introduction: This article reports two cases of submacular choroidal granuloma from sarcoidosis, highlighting the critical importance of timely diagnosis and treatment for both visual and systemic prognosis. Case studies: Case 1 is a 60-year-old man who presented with blurred vision from a submacular choroidal granuloma. Initially, the lesion responded to oral prednisone, however, there was progression once the prednisone was stopped. One year later, he developed complete heart block and was diagnosed with cardiac sarcoidosis. He underwent pacemaker implantation and has been maintained on mycophenolate. Case 2 is a 35-year-old man who presented with distortion from a submacular choroidal granuloma that similarly responded to oral prednisone but progressed after it was discontinued. He had a chest computerized tomography scan and a subsequent lymph node biopsy that confirmed the diagnosis of sarcoidosis. He has remained stable and healthy, with 20/20 vision on methotrexate. Conclusion: Submacular choroidal granuloma from sarcoidosis is a rare condition that can cause vision loss if not treated promptly. These lesions usually respond to local or systemic corticosteroids. Diagnosis of these lesions is critical not only for visual preservation but also to prevent systemic complications.
{"title":"Submacular Choroidal Granuloma from Sarcoidosis: A Case Report","authors":"Jacob Duker, Priya Vakharia, J. Duker, L. Rifkin, C. Shah","doi":"10.17925/usor.2023.17.1.42","DOIUrl":"https://doi.org/10.17925/usor.2023.17.1.42","url":null,"abstract":"Introduction: This article reports two cases of submacular choroidal granuloma from sarcoidosis, highlighting the critical importance of timely diagnosis and treatment for both visual and systemic prognosis. Case studies: Case 1 is a 60-year-old man who presented with blurred vision from a submacular choroidal granuloma. Initially, the lesion responded to oral prednisone, however, there was progression once the prednisone was stopped. One year later, he developed complete heart block and was diagnosed with cardiac sarcoidosis. He underwent pacemaker implantation and has been maintained on mycophenolate. Case 2 is a 35-year-old man who presented with distortion from a submacular choroidal granuloma that similarly responded to oral prednisone but progressed after it was discontinued. He had a chest computerized tomography scan and a subsequent lymph node biopsy that confirmed the diagnosis of sarcoidosis. He has remained stable and healthy, with 20/20 vision on methotrexate. Conclusion: Submacular choroidal granuloma from sarcoidosis is a rare condition that can cause vision loss if not treated promptly. These lesions usually respond to local or systemic corticosteroids. Diagnosis of these lesions is critical not only for visual preservation but also to prevent systemic complications.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.17925/usor.2023.17.1.21
Pamela Davila-Siliezar, Noor Laylani, K. A. Douglas, D. Milea, Andrew G. Lee
Leber hereditary optic neuropathy (LHON) is the most common primary mitochondrial DNA disorder, presenting typically as a sequential, painless, subacute, optic neuropathy in young males. Despite the very limited therapeutic options in LHON, recent developments involving novel pharmacological agents and emerging gene therapy interventions have shown promising results for improved visual outcomes. A synthetic analogue of coenzyme Q (idebenone) is the most common medical treatment in LHON. In a multicentre, double-blind randomized, placebo-controlled clinical trial (Rescue of Hereditary Optic Disease Outpatient Study [RHODOS]), a dose of 900 mg/day of idebenone for 24 weeks was found to be well tolerated and safe. In a follow-up study (RHODOS-OFU), the visual acuity of 70% of patients enrolled in RHODOS was reassessed 30 months after discontinuation of idebenone. Results from this study suggested that visual acuity continued to improve even after discontinuation of the drug. Gene therapy has recently emerged as a potential treatment for LHON. RESCUE and REVERSE were two phase III clinical trials of viral-mediated gene therapy using lenadogene nolparvovec intravitreal injections in patients with early-stage LHON. Results in these trials have shown long-term safety and bilateral visual acuity improvement after unilateral intravitreal injections at 96 weeks, and sustained visual improvement after 3 years of treatment. The most recent phase III clinical trial in LHON (REFLECT) has shown significant improvement of vision after bilateral intravitreal injections of lenadogene nolparvovec compared with unilateral injections. These promising results suggest that, in the near future, LHON might become the first mitochondrial disorder to benefit from gene therapy.
{"title":"Current and Emerging Therapies for Leber Hereditary Optic Neuropathy","authors":"Pamela Davila-Siliezar, Noor Laylani, K. A. Douglas, D. Milea, Andrew G. Lee","doi":"10.17925/usor.2023.17.1.21","DOIUrl":"https://doi.org/10.17925/usor.2023.17.1.21","url":null,"abstract":"Leber hereditary optic neuropathy (LHON) is the most common primary mitochondrial DNA disorder, presenting typically as a sequential, painless, subacute, optic neuropathy in young males. Despite the very limited therapeutic options in LHON, recent developments involving novel pharmacological agents and emerging gene therapy interventions have shown promising results for improved visual outcomes. A synthetic analogue of coenzyme Q (idebenone) is the most common medical treatment in LHON. In a multicentre, double-blind randomized, placebo-controlled clinical trial (Rescue of Hereditary Optic Disease Outpatient Study [RHODOS]), a dose of 900 mg/day of idebenone for 24 weeks was found to be well tolerated and safe. In a follow-up study (RHODOS-OFU), the visual acuity of 70% of patients enrolled in RHODOS was reassessed 30 months after discontinuation of idebenone. Results from this study suggested that visual acuity continued to improve even after discontinuation of the drug. Gene therapy has recently emerged as a potential treatment for LHON. RESCUE and REVERSE were two phase III clinical trials of viral-mediated gene therapy using lenadogene nolparvovec intravitreal injections in patients with early-stage LHON. Results in these trials have shown long-term safety and bilateral visual acuity improvement after unilateral intravitreal injections at 96 weeks, and sustained visual improvement after 3 years of treatment. The most recent phase III clinical trial in LHON (REFLECT) has shown significant improvement of vision after bilateral intravitreal injections of lenadogene nolparvovec compared with unilateral injections. These promising results suggest that, in the near future, LHON might become the first mitochondrial disorder to benefit from gene therapy.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.17925/usor.2023.17.1.8
S. Adrean
The introduction of vascular endothelial growth factor inhibitors has led to significant improvements for patients with neovascular age-related macular degeneration (nAMD) and diabetic macular oedema (DMO). Landmark trials – such as ANCHOR, MARINA and VIEW for nAMD and RIDE/RISE, VIVID and VISTA for DMO – showed positive results, including clinically meaningful gains in Early Treatment Diabetic Retinopathy Study letters, with anti-vascular endothelial growth factor agents now the standard of care for nAMD and DMO. More recent studies, including those investigating high-dose aflibercept in nAMD and DMO, have focused on durability of response by studying increased treatment intervals to reduce the treatment burden on patients and physicians alike. The PULSAR (nAMD) and PHOTON (DMO) trials included high-dose (8 mg) aflibercept at either 12-week or 16-week dosing intervals and showed non-inferior visual gains compared with the standard dose of 2 mg, with ≥83% of patients maintaining their extended dosing interval throughout the 48-week studies. This is certainly an exciting development, and it will be interesting to see how extended treatment durability will impact management paradigms for patients with nAMD and DMO.
{"title":"High-dose Aflibercept with Increased Dosing Intervals as a New Standard of Care for DMO and nAMD","authors":"S. Adrean","doi":"10.17925/usor.2023.17.1.8","DOIUrl":"https://doi.org/10.17925/usor.2023.17.1.8","url":null,"abstract":"The introduction of vascular endothelial growth factor inhibitors has led to significant improvements for patients with neovascular age-related macular degeneration (nAMD) and diabetic macular oedema (DMO). Landmark trials – such as ANCHOR, MARINA and VIEW for nAMD and RIDE/RISE, VIVID and VISTA for DMO – showed positive results, including clinically meaningful gains in Early Treatment Diabetic Retinopathy Study letters, with anti-vascular endothelial growth factor agents now the standard of care for nAMD and DMO. More recent studies, including those investigating high-dose aflibercept in nAMD and DMO, have focused on durability of response by studying increased treatment intervals to reduce the treatment burden on patients and physicians alike. The PULSAR (nAMD) and PHOTON (DMO) trials included high-dose (8 mg) aflibercept at either 12-week or 16-week dosing intervals and showed non-inferior visual gains compared with the standard dose of 2 mg, with ≥83% of patients maintaining their extended dosing interval throughout the 48-week studies. This is certainly an exciting development, and it will be interesting to see how extended treatment durability will impact management paradigms for patients with nAMD and DMO.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.2.63
Brandon J. Baartman
There are numerous keys to successful modern cataract surgery, but to produce truly happy postoperative patients, the results of the surgery must also meet the patient’s expectations. In order to properly set expectations, patients must be educated about cataracts themselves, lens implant options, the experience of having cataract surgery and what to expect afterwards. This article reviews the various patient education tools in use today.
{"title":"The State of Preoperative Patient Education for Cataract Surgery","authors":"Brandon J. Baartman","doi":"10.17925/usor.2022.16.2.63","DOIUrl":"https://doi.org/10.17925/usor.2022.16.2.63","url":null,"abstract":"There are numerous keys to successful modern cataract surgery, but to produce truly happy postoperative patients, the results of the surgery must also meet the patient’s expectations. In order to properly set expectations, patients must be educated about cataracts themselves, lens implant options, the experience of having cataract surgery and what to expect afterwards. This article reviews the various patient education tools in use today.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.1.2
J. Meyer
Demodex blepharitis is a highly prevalent lid margin disease that affects approximately 25 million people in the USA, yet is often missed or misdiagnosed. Many patients experience signs and symptoms including the presence of collarettes, lid erythema, and itchy and dry eyes, and psychosocial impacts such as feeling self-conscious about their eyes, or difficulties with night-time driving or wearing make-up. There are currently no therapeutics approved by the US Food and Drug Administration to treat Demodex blepharitis, but a novel molecule, lotilaner, has demonstrated statistically significant improvements for patients.
{"title":"Novel Molecule Lotilaner Could Potentially Offer Relief to Long-suffering Demodex Blepharitis Patients","authors":"J. Meyer","doi":"10.17925/usor.2022.16.1.2","DOIUrl":"https://doi.org/10.17925/usor.2022.16.1.2","url":null,"abstract":"Demodex blepharitis is a highly prevalent lid margin disease that affects approximately 25 million people in the USA, yet is often missed or misdiagnosed. Many patients experience signs and symptoms including the presence of collarettes, lid erythema, and itchy and dry eyes, and psychosocial impacts such as feeling self-conscious about their eyes, or difficulties with night-time driving or wearing make-up. There are currently no therapeutics approved by the US Food and Drug Administration to treat Demodex blepharitis, but a novel molecule, lotilaner, has demonstrated statistically significant improvements for patients.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622442","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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