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 pathway t...
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, and fu...
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
