Challenges in management of the Boston Keratoprosthesis Type 1
Purpose of review The Boston Keratoprosthesis Type 1 was pioneered by Claes Dohlman several decades ago. Since its inception, the device has undergone multiple revisions to address challenges associated with retroprosthetic membrane formation, retention, extrusion, stromal melt and endophthalmitis. Although visual outcomes and retention rates have improved, challenges, especially glaucoma, remain. Recent findings The Boston Keratoprosthesis Type I device has seen an increase in popularity because of the improvement in rates of retention and visual rehabilitation. Recent outcome studies have allowed clinicians to...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

The role of environment in the pathogenesis of keratoconus
This study was conducted to demonstrate the importance of the environment in keratoconus (KC) genesis. Recent findings Genetic-related connective tissue disorders demonstrate the inconsistency of theories regarding KC pathogenesis since no corneal steepening was observed in the majority of these patients. Despite recent advances and decades of research into the genetics of KC, the identification of disease-causing KC genes has been frustrating. Variants found based on genome-wide and next-generation sequencing only seem to account for a small number of cases or play a limited role in KC pathogenesis. Summary ...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

The role of imaging technologies for ocular surface tumors
Purpose of review This review will discuss the utility of high-resolution anterior segment optical coherence tomography (HR-OCT), in-vivo confocal microscopy (IVCM) and ultrasound biomicroscopy (UBM) in characterizing and diagnosing various ocular surface tumors, namely ocular surface squamous neoplasia (OSSN), conjunctival lymphoma and conjunctival melanoma. The strengths and limitations of each imaging modality will be discussed along with the characteristics findings of each lesion on each imaging platform. Recent findings HR-OCT can consistently be utilized in the clinic setting to distinguish between epithe...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

The management of neurotrophic keratitis
Purpose of review The management of neurotrophic keratitis (NK) has evolved in the last decade. The present article reviews updated management guidelines of this entity, as well as future innovations in the field. Recent findings The advent of confocal microscopy has allowed for the first time to image corneal nerves. In addition, multiple novel topical treatments such as nerve growth factor have improved the prognosis of this disease, with many other in the pipeline. Finally, corneal nerve restoration is now possible with corneal neurotization procedures. Summary Many novel treatments based on agents tha...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Alternative therapies for dry eye disease
Purpose of review Dry eye disease (DED) is a multifactorial disease affecting approximately 5–50% of individuals in various populations. Contributors to DED include, but are not limited to, lacrimal gland hypofunction, meibomian gland dysfunction (MGD), ocular surface inflammation, and corneal nerve dysfunction. Current DED treatments target some facets of the disease, such as ocular surface inflammation, but not all individuals experience adequate symptom relief. As such, this review focuses on alternative and adjunct approaches that are being explored to target underlying contributors to DED. Recent findings...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Update on corneal collagen crosslinking for ectasia
Purpose of review Corneal collagen crosslinking (CXL) is a minimally invasive treatment that can stabilize corneal ectatic disorders including keratoconus, pellucid marginal degeneration, or postrefractive surgery ectasia. The benefits of CXL have been well documented. New research is focused on modifying current treatment protocols with the goals of maximizing corneal stability while also shortening overall procedure time. Recent findings Accelerated CXL protocols have the goal of delivering the same ultraviolet A intensity as conventional protocols, but over a shorter time period. Accelerated protocols have sh...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Updated safety precautions and guidance on eye banking procedures during the coronavirus disease 2019 pandemic
Purpose of review severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious coronavirus causing the COVID-19 pandemic. Although airborne spread through infectious respiratory droplets is the primary source of transmission, recent literature has suggested the ocular surface may be able to harbor viral particles. Here, we aim to discuss how SARS-CoV-2 affects the ocular surface and updated guidance on how SARS-CoV-2 transmission should be considered in the setting of eye banking and corneal transplantation procedures. Recent findings SARS-CoV-2 RNA can be found on the ocular surface, whic...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Advances in corneal graft rejection
Purpose of review Immune rejection after corneal transplantation is a major risk for graft failure. We aim to summarize recent advances in the understanding and management of graft rejection. Recent findings Immune rejection remains the leading cause of graft failure in penetrating keratoplasty (PKP). While ABO blood type and sex match between donor and recipient may reduce rejection, human leucocyte antigens class II matching in a randomized study did not reduce the risk of rejection in high-risk PKP. Compared with PKP, deep anterior lamellar keratoplasty, descemet stripping automated endothelial keratoplasty, ...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

What's trending: a review of social media in ophthalmology
Purpose of review With social media use continuing to increase in popularity, ophthalmologists use social media daily for interactions with patients, colleagues, and the academic community. Recent findings The potential reach of social media is overwhelmingly encouraging, but academic organizations have much work to do in order to compete for viewership on social media platforms, and users need to remain vigilant of easily spread misinformation. Individual ophthalmology practices can tailor their social media presence to attract and educate patients. Using hashtags to supplement the experience of academic confer...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Pharmacological strategies for treating presbyopia
Purpose of review Presbyopia is the normal progressive loss of accommodation, which leads to the inability to focus clearly on objects located at different distances. Some of the accepted methods for treating this condition are glasses, contact lenses, and surgery. Pharmacological treatments are a new and promising noninvasive option for dealing with presbyopia. The aim of this review is to provide an update on some recent advances in this field. Recent findings Currently, there are three different strategies for the pharmacological treatment of presbyopia. The first one aims to produce miosis and increase depth...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Neurotrophic keratopathy and refractive surgery
Purpose of review Corneal nerve function is an important consideration for the refractive surgeon. In patients without a history of neuropathy, refractive surgery can lead to destruction of corneal nerves and may predispose to keratopathy. The purpose of this review is to provide an update on the effect of refractive surgery on corneal nerve function and the potential for an increased risk of neurotrophic keratopathy development. Recent findings Recent studies have reinforced that refractive surgery can cause anatomical and functional changes in corneal nerve function. Among the most commonly performed refractiv...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Postrefractive infectious keratitis: prevention, diagnosis, management, and prognosis
Purpose of review Improve outcomes from an elective procedure by preventing a rare but sight-threatening complication. Recent findings Advancement in anti-infective prophylaxis, and therefore shift in the causative organism permits better diagnostic and empiric management. Summary Infectious keratitis presents in different patterns depending on the refractive procedure. Atypical causative organisms may respond poorly to empiric therapy and impair vision. Therefore, microbial identification is of utmost importance and therapy is adjusted accordingly. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Uveal melanoma: laboratory advances and new frontiers in patient care
Purpose of review To review recent advancements in the genetic understanding, diagnosis, prognosis, and treatment of uveal melanoma (UM). Recent findings UM is a molecularly distinct melanocytic malignancy driven by mutations in GNAQ or GNA11, with mitogen-activated protein kinase pathway upregulation. Earlier diagnosis and treatment are important factors for improving life prognosis. These goals can be aided by more objective multimodal imaging risk factors for the prediction of malignant nevus transformation and novel treatment strategies such as customized radiation fields and nanoparticle therapy to reduce v...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Emerging treatments for geographic atrophy in age-related macular degeneration
Purpose of review This review describes therapeutic research programs for geographic atrophy (GA) due to age-related macular degeneration (AMD). We highlight clinical trial data from phase I, II, and III studies. Recent findings There are currently no treatments for GA, a form of advanced AMD that causes significant visual morbidity. Currently, therapeutic candidates are being developed to delay further progression of GA or even attempt to reverse some of the damage. The approaches to therapy range from molecular targets to cell transplantation. Studies of these novel treatment approaches have demonstrated varyi...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Novel vitreous substitutes: the next frontier in vitreoretinal surgery
Purpose of review After removing the native vitreous during vitreoretinal surgery, an adequate substitute is required to ensure homeostasis of the eye. Current clinically used endotamponades (silicone oil, gases, semifluorinated alkanes) are effective in promoting retinal reattachment, but lead to complications such as emulsification, prolonged inflammation, blurred vision, raised intraocular pressure, cataract formation or the need for revision surgery. The aim of this review is to provide an update on novel vitreous substitutes with a focus on polymer-based systems. Recent findings Polymeric hydrogels provide ...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Metabolic syndrome and the aging retina
Purpose of review This review explores metabolic syndrome (MetS) as a risk factor that accelerates aging in retinal neurons and may contribute to the neurodegeneration seen in glaucomatous optic neuropathy (GON) and age-related macular degeneration (AMD). Recent findings Both animal model experiments and epidemiologic studies suggest that metabolic stress may lead to aberrant regulation of a number of cellular pathways that ultimately lead to premature aging of the cell, including those of a neuronal lineage. Summary GON and AMD are each leading causes of irreversible blindness worldwide. Aging is a signi...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

In-vivo imaging of the conventional aqueous outflow system
Purpose of review The aim of this study was to provide a comprehensive summary of in-vivo imaging techniques of the aqueous outflow system and discuss its role in improving our understanding of glaucoma pathogenesis and management. Recent findings Our understanding of the aqueous outflow system is largely derived from ex-vivo studies. Recent innovations in imaging technology and techniques enable in-vivo evaluation of the conventional outflow system in real-time. Optical coherence tomography allows for noninvasive, high-resolution, volumetric imaging of ocular tissues. Dynamic structural changes have been observ...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Rho kinase (ROCK) inhibitors in the management of corneal endothelial disease
Purpose of review Rho kinase (ROCK) inhibitors are growing increasingly relevant in ophthalmology, and the goal of this review is to summarize their mechanisms of action and potential applications in the subspecialties of glaucoma, retina, and cornea. We will focus specifically on corneal endothelial wound healing, for which ROCK inhibition demonstrates particular promise. Recent findings ROCK inhibition has been shown to promote corneal endothelial cell proliferation, increase intercellular adhesion, and suppress apoptosis. Topical ROCK inhibitor treatment has exhibited potential use in Fuchs endothelial dystro...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Current and future therapies for persistent corneal epithelial defects and neurotrophic keratopathy
Purpose of review The corneal epithelium is a crucial barrier against pathogens, and when disrupted in the setting of certain underlying risk factors such as neurotrophic keratopathy (NK), may result in persistent epithelial defects (PEDs) of the cornea. Management is challenging and may require a variety of different approaches ranging from conservative medical therapy to surgical intervention. The purpose of this review is to provide an update on current and potential future therapeutic options for PEDs and NK. Recent findings Recent research has yielded promising results for numerous novel therapies aimed at ...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Orbital inflammatory disorders: new knowledge, future challenges
Purpose of review This review aims to bring together recent advances in basic, translational and clinical research on the pathogenesis and treatment of orbital inflammatory conditions. Recent findings Basic science studies provide mechanistic insights into why the orbit is targeted for inflammation by autoimmune inflammatory disorders. Using Graves’ disease as a test case reveals that endocrine pathways, such as the TSH and IGF1 receptor pathways play important roles in stimulating orbital inflammation. Furthermore, orbital tissues contain high concentrations of retinoids – byproducts of the visual p...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Editorial: Current opinion in ophthalmology: translational ophthalmology 2021 editorial
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Geographic atrophy: where we are now and where we are going
Purpose of review Age-related macular degeneration (AMD) affects a significant percentage of the elderly population and end-stage disease classified by either geographic atrophy (GA) or neovascular AMD (nvAMD) is one of the leading causes of vision loss worldwide. Despite the fact that there are currently treatments for nvAMD, there are no treatments in practice to prevent disease onset or progression of GA. This topic is at the forefront of ophthalmic research demonstrated by the recent advances in disease characterization, genetic and environmental risk factor classification, biomarker discovery and mechanism of path...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Current status of home monitoring technology for age-related macular degeneration
Purpose of review Evidence suggests that patients present with exudative age-related macular degeneration (AMD) in a delayed fashion. Increased lesion size associated with this delay directly impacts visual acuity. Upon treatment initiation, patients are monitored largely with optical coherence tomography (OCT) technology to determine the need for treatment. Home-monitoring systems using preferential hyperacuity perimetry (PHP) and OCT may optimize management. Recent findings Comparison of Age-related Macular Degeneration Treatment Trials study and American Academy of Ophthalmology's Intelligent Research in Sigh...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Update on maculopathy secondary to pentosan polysulfate toxicity
Purpose of review The aim of the present review is to provide a comprehensive summary of available knowledge regarding toxic maculopathy secondary to pentosan polysulfate sodium (PPS). Recent findings PPS toxicity was described in 2018, and additional studies characterize it as dysfunction of the retinal pigment epithelium centered on the posterior pole, which can progress despite drug cessation. Requisite exposure can be as little as 0.325 kg and 2.25 years but averages closer to 1–2 kg and 10–15 years. Multimodal imaging should include near-infrared reflectance, optical coherence tomography...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Photobiomodulation therapy in age-related macular degeneration
Purpose of review To review the available data supporting the use of photobiomodulation therapy (PBT) in the treatment of age-related macular degeneration (AMD). Recent findings PBT might be used in treating nonexudative AMD. Limited evidence suggests that exudative AMD may also benefit from PBT. Summary The optimal device would deliver doses of 60 J/cm2 or more with a multiwavelength composition through the pupil over short treatment intervals. Safe upper limits have not been established. More studies are needed to evaluate the efficacy of PBT in treating exudative and nonexudative AMD. (Source: Curren...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Stargardt disease masquerades
Purpose of review Stargardt disease is the most common inherited macular dystrophy but has a wide clinical spectrum, and several inherited macular dystrophies have phenotypic similarities that can make clinical diagnosis challenging. This review seeks to highlight key clinical and multimodal imaging features to aid clinicians in accurate diagnosis. Recent findings Multimodal imaging has provided additional information to aid in the diagnosis of Stargardt disease and its masquerades. These data from multimodal imaging are important to correlate with findings from clinical examination to help support the clinical ...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Opioids and ophthalmology: review of the current literature
Purpose of review The number of opioid-related overdose deaths has rapidly increased since 2000, increasing more than five-fold from 1999 to 2016. Although surgeons only write 10% of opioid prescriptions annually, with ophthalmologists writing only a fraction of this amount, all physicians need to be cognizant of the current opioid epidemic and ways to decrease unnecessary opioid prescriptions. Recent findings Previous work within ophthalmology has shown that retrobulbar anesthesia along with peri-operative intravenous or oral nonopioid analgesics can lead to decreased postoperative opioid use following ophthalm...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Early pars plana vitrectomy for proliferative diabetic retinopathy: update and review of current literature
Purpose of review Diabetic retinopathy (DR) is one of the leading causes of preventable vision loss in the world and its prevalence continues to increase worldwide. One of the ultimate and visually impairing complications of DR is proliferative diabetic retinopathy (PDR) and subsequent tractional retinal detachment. Treatment modalities, surgical techniques, and a better understanding of the pathophysiology of DR and PDR continue to change the way we approach the disease. The goal of this review is to provide an update on recent treatment modalities and outcomes of proliferative diabetic retinopathy and its complicatio...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Current treatment strategies for symptomatic vitreous opacities
Purpose of review Symptomatic vitreous opacities are increasingly recognized as a significant burden to patient well-being. There is growing interest in the use of vitrectomy or laser treatment to address these problems. This review is intended to update current assessment, management, and risks of treatment for persistent severely symptomatic vitreous opacities. Recent findings Despite studies showing the value of quantitative ultrasound, reading speed measurements, and contrast sensitivity for assessing dysfunction caused by vitreous opacities, the decision of whether to proceed with surgery remains a very sub...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Drug-related adverse effects of antivascular endothelial growth factor agents
Purpose of review Antivascular endothelial growth factor (VEGF) agents have provided historic therapeutic breakthroughs in the treatment of retinal disease. New anti-VEGF agents are emerging for the treatment of retinal vascular diseases. Both systemic and ocular adverse effect need to be understood in managing patients. This review aims to highlight the adverse effects seen with routine use of bevacizumab, ranibizumab and aflibercept, as well as with new medications such as brolucizumab and abicipar. Recent findings We review the recent findings of intraocular inflammation (IOI) of brolucizumab and abicipar in ...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Radiation therapy for uveal melanoma: a review of treatment methods available in 2021
Purpose of review Radiation therapy has become the standard of care for the treatment of uveal melanoma. We intend to outline the current radiation therapy methods that are employed to treat uveal melanoma. We will outline their relative benefits over one another. We will also provide some background about radiation therapy in general to accustom the ophthalmologists likely reading this review. Recent findings Four main options exist for radiation therapy of uveal melanoma. Because the eye is a small space, and because melanomas are relatively radioresistant, oncologists treating uveal melanoma must deliver high...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Multimodal imaging in infectious and noninfectious intermediate, posterior and panuveitis
Purpose of review Given the heterogeneity of uveitis, markers of inflammation vary from patient to patient. Multimodal imaging has proven itself to be critical for accurate evaluation for disease activity and treatment response in uveitis. Recent findings Ultra-widefield (UWF) fluorescein angiography and autofluorescence (AF) as well as optical coherence tomography angiography (OCTA) have provided insights into disease pathogenesis and monitoring not previously appreciated. In addition to structural retinal imaging, OCT can be used to assess the choroid, the posterior cortical vitreous and the retinal vasculatur...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Safety profile of minimally invasive glaucoma surgery
This article reviews the safety profile of trabecular meshwork/Schlemm's canal-based, subconjunctival, and suprachoroidal minimally invasive glaucoma surgery (MIGS). Recent findings Prospective randomized clinical trials and metaanalyses published during the 2019–2020 review period provided important data regarding the safety profile of trabecular meshwork/Schlemm's canal-based MIGS. Transient hyphema and intraocular pressure spikes are among the most common complications associated with this category of MIGS, but more serious adverse events such as cyclodialysis cleft formation may also occur. Trabecular bypa...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

History, presence, and future of mitomycin C in glaucoma filtration surgery
Purpose of review Mitomycin C (MMC) is an alkylating agent with extraordinary ability to crosslink DNA, preventing DNA synthesis. By this virtue, MMC is an important antitumor drug. In addition, MMC has become the gold standard medication for glaucoma filtration surgery (GFS). This eye surgery creates a passage for drainage of aqueous humor (AqH) out of the eye into the sub-Tenon's space with the aim of lowering the intraocular pressure. A major cause of failure of this operation is fibrosis and scarring in the sub-Tenon's space, which will restrict AqH outflow. Intraoperative application of MMC during GFS has increase...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Is laser trabeculoplasty the new star in glaucoma treatment?
Purpose of review For decades, laser trabeculoplasty has been a well-proven therapeutic option in glaucoma management, and more recently, it has only gained in popularity. One reason for such popularity is that selective laser trabeculoplasty (SLT) is a therapy independent of patient adherence, which is typically low among glaucoma patients. Consequently, the number of studies on SLT has multiplied throughout the past years. This review provides an overview of studies on SLT from the last 12 months. Recent findings The studies on treatment outcome show a wide range of success rates of SLT reaching between 18 and...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

New strategies for the management of ocular surface disease in glaucoma patients
Purpose of review Glaucoma patients commonly suffer from ocular surface disease (OSD). As treatment strategies, medications and devices for the treatment of OSD as well as glaucoma surgical approaches evolve rapidly, it is important to consider their application to these patients. Recent findings OSD in glaucoma patients may lead to reduced reliability of diagnostic tests, decreased medication compliance, poor surgical outcomes, and overall decreased quality of life. Chronic use of topical glaucoma medications has been linked to the development of limbal stem cell deficiency, and the role of preservatives in OSD...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Advances in medical therapy for glaucoma
Purpose of review To discuss a new class of medication that has recently become available for the treatment of glaucoma; as well as share insights into developments in glaucoma medicine administration which has the potential to revolutionize medical therapy for glaucoma. Recent findings Newly available eye drops, netarsudil 0.02% and latanoprostene bunod 0.024%, are improving aqueous outflow through the conventional outflow tract. Other new developments in medical glaucoma are focused on alternative methods for sustained glaucoma medication delivery. Summary Newer medications may be able to extend the dur...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Pseudoexfoliation syndrome and glaucoma: from genes to disease mechanisms
Purpose of review The genetic basis of pseudoexfoliation (PEX) syndrome, the most common identifiable cause of open-angle glaucoma, is steadily being elucidated. This review summarizes the recent advances on genetic risk factors for PEX syndrome/glaucoma and their potential functional implications in PEX pathophysiology. Recent findings As of today, seven loci associated with the risk of PEX surpassing genome-wide significance have been identified by well-powered genome-wide association studies and sequencing efforts. LOXL1 (lysyl oxidase-like 1) represents the major genetic effect locus, although the biological...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Artificial intelligence and complex statistical modeling in glaucoma diagnosis and management
Purpose of review The field of artificial intelligence has grown exponentially in recent years with new technology, methods, and applications emerging at a rapid rate. Many of these advancements have been used to improve the diagnosis and management of glaucoma. We aim to provide an overview of recent publications regarding the use of artificial intelligence to enhance the detection and treatment of glaucoma. Recent findings Machine learning classifiers and deep learning algorithms have been developed to autonomously detect early structural and functional changes of glaucoma using different imaging and testing m...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Recent developments in the use of optical coherence tomography for glaucoma
Purpose of review The aim of this article is to summarize findings of recent reports highlighting the utility of novel optical coherence tomography (OCT) parameters in the diagnosis and monitoring of glaucomatous optic neuropathy. Recent findings Optic nerve head (ONH), retinal nerve fiber layer (RNFL), and macular parameters show high levels of diagnostic capability. The Bruch's membrane opening-minimum rim width (BMO-MRW) measurement is a novel ONH parameter obtained using the Spectralis SD-OCT device (Heidelberg Engineering, Inc., Heidelberg, Germany). The inferotemporal BMO-MRW sector shows the highest diagn...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Advances in perimetry for glaucoma
Purpose of review Perimetry remains important for the diagnosis and management of glaucoma despite advances in imaging technology. The purpose of this review is to describe advances in the acquisition and analysis of visual field data and highlight novel techniques for performing perimetry. Recent findings Studies have focused on improving the detection of patients at highest risk of severe vision loss and the development of innovative testing strategies that allow for more frequent testing. Artificial intelligence has been utilized in research settings to improve detection and characterization of glaucomatous f...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

The role of clinical examination of the optic nerve head in glaucoma today
Purpose of review The study was undertaken to assess the current importance of clinical examination of the optic nerve head (ONH) in glaucoma management. Recent findings ONH changes in glaucoma are easily assessed with good specificity on examination, whereas imaging has not been able to identify pallor of the neuroretinal rim (NRR), disc hemorrhages, or vascular signs of acquired cupping. Glaucomatous neuropathy in primary open angle glaucoma (POAG) has extensive databases on imaging machines, however, other glaucomas such as primary angle closure glaucoma (PACG), juvenile open angle glaucoma (JOAG), congenital...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Glaucoma care during the coronavirus disease 2019 pandemic
Purpose of review The current article reviews the impact of the coronavirus disease 2019 (COVID-19) pandemic on the delivery of ophthalmic, and specifically, glaucoma care. Recent findings Literature from the review period includes case series demonstrating the presence of severe acute respiratory syndrome coronavirus 2 RNA in the conjunctival secretions of patients with laboratory-confirmed COVID-19. The global ophthalmology community published reports outlining the enhanced infection control measures undertaken by different institutions around the world to mitigate transmission of the novel coronavirus. Teleme...
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - February 13, 2021 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Visual disturbances during prolonged space missions
This article reviews symptoms, likely causes, and potential solutions, such as lower body negative pressure, to counteract space-associated neuroocular syndrome (SANS). Recent findings Low gravity conditions and other aspects of spaceflight affect the eye detrimentally, causing SANS which is characterized by optic disc edema, choroidal thickening, cotton wool spots, and a hyperopic shift. SANS is probably caused by altered hemodynamic flows in the head and neck as well as mildly elevated intracranial and intraocular pressures. Carbon dioxide and other chemicals in space-craft may influence SANS as well. SANS may be ...
Source: Current Opinion in Ophthalmology - December 4, 2020 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Endophthalmitis after cataract surgery: an update on recent advances
Purpose of review Prevention and management of postcataract endophthalmitis remain quite relevant for anterior segment and vitreoretinal surgeons. Although the Endophthalmitis Vitrectomy Study, published in 1996, remains the only level 1 evidence for the management of postcataract endophthalmitis, recent advances have resulted in an evolution of practice patterns. The aim of this review is to summarize the literature regarding postcataract endophthalmitis with a focus on the last 18 months. Recent findings The IRIS registry indicates the rates of endophthalmitis are decreasing in the United States, and the outco...
Source: Current Opinion in Ophthalmology - December 4, 2020 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Refractive enhancements for residual refractive error after cataract surgery
Purpose of review Advances in cataract surgery have allowed surgeons to achieve superior refractive outcomes but have also led to higher patient expectations. Despite ever-evolving technology, residual refractive errors still occur. Postcataract refractive enhancements may be required to deliver satisfactory visual outcomes. This review aims to discuss the potential causes of residual refractive errors and the various enhancement modalities to correct them. Recent findings A thorough preoperative workup to detect and address underlying pathologic causes of impaired vision should be performed prior to enhancement...
Source: Current Opinion in Ophthalmology - December 4, 2020 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Use of presbyopia-correcting intraocular lenses in patients with prior corneal refractive surgery
Purpose of review Corneal refractive surgery has achieved spectacle-free vision for millions of patients, but this aging population is now developing cataracts. Many of these patients may wish to avoid reliance on glasses after cataract surgery. Presbyopia-correcting intraocular lenses (IOLs) offer a solution, but corneal changes after refractive surgery may compound higher order aberrations and dysphotopic symptoms associated with these IOLs. This review aims to discuss potential factors that could aid in determining suitable postkeratorefractive candidates for presbyopia-correcting IOLs. Recent findings Studie...
Source: Current Opinion in Ophthalmology - December 4, 2020 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research